Evidence map›Paper›PMID 31101018›Full record

Trial reportBMC nephrology2019

The effect of increased frequency of hemodialysis on vitamin C concentrations: an ancillary study of the randomized Frequent Hemodialysis Network (FHN) daily trial.

Jochen G Raimann, Samer R Abbas, Li Liu, Brett Larive, Gerald Beck, Peter Kotanko, Nathan W Levin, Garry Handelman, FHN Trial

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 4 pooled it
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Interventions for fatigue in people with kidney failure requiring dialysis.The Cochrane database of systematic reviews · 2023
    Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Jochen G RaimannRenal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY, 10065, USA. Jochen.Raimann@rriny.com.ORCID 0000-0002-8954-2783
Samer R AbbasRenal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY, 10065, USA.
Li LiuRenal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY, 10065, USA.
Brett LariveCleveland Clinic Foundation, Cleveland, OH, USA.
Gerald BeckCleveland Clinic Foundation, Cleveland, OH, USA.
Peter KotankoRenal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY, 10065, USA.
Nathan W LevinRenal Research Institute, 315 East 62nd Street, 4th Floor, New York, NY, 10065, USA.
Garry HandelmanUniversity of Massachusetts Lowell, Lowell, MA, USA.
FHN Trial
Cleveland Clinic · USRenal Research Institute · USMount Sinai Health System · USUniversity of Massachusetts Lowell · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReports on vitamin C in HD patients have shown effects of vitamin C deficiency in association with scurvy symptoms. Dialyzability of water soluble vitamins is high, and substantial losses in those who are dialyzed more frequently were hypothesized. The randomized FHN Daily Trial compared the effects of in-center HD six versus three times per week. We studied baseline correlations between vitamin C and potentially associated parameters, and the effect of more frequent HD on circulating vitamin C concentrations.

methodsWe studied vitamin C levels at baseline and months, 3, 5 and 11. Patients enrolled between 2007 and 2009 into the randomized FHN Daily trial in the East Coast consortium were approached for participation. Predialysis plasma samples were processed with metaphosphoric acid and frozen at - 70 °C for measurement with HPLC. Regression models between baseline log-transformed vitamin C and hemoglobin, CRP, eKt/V, ePCR and PTH, and a linear mixed-effects model to estimate the effect size of more frequent HD on plasma vitamin C, were constructed.

resultsWe studied 44 subjects enrolled in the FHN Daily trial (50 ± 12 years, 36% female, 29% Hispanics and 64% blacks, 60% anuric). Vitamin C correlated significantly with predialysis hemoglobin (r = 0.3; P = 0.03) and PTH (r = - 0.3, P = 0.04), respectively. Vitamin C did not significantly differ at baseline (6×/week, 25.8 ± 25.9 versus 3×/week, 32.6 ± 39.4 μmol/L) and no significant treatment effect on plasma vitamin C concentrations was found [- 26.2 (95%CI -57.5 to 5.1) μmol/L at Month 4 and - 2.5 (95%CI -15.6 to 10.6) μmol/L at Month 12.

conclusionsBased on data from this large randomized-controlled trial no significant effect of the intervention on circulating plasma vitamin C concentrations was found, allaying the concerns that more frequent HD would affect the concentrations of water-soluble vitamins and adversely affect patient's well-being. Correlations between vitamin C and hemoglobin and PTH support the importance of vitamin C for normal bone and mineral metabolism, and anemia management.

Indexed as

AdultAscorbic AcidFemaleHumansKidney Failure, ChronicMaleMiddle AgedProspective StudiesRenal DialysisTreatment OutcomeAscorbic AcidClinical trialsFrequent hemodialysis network (FHN)HemodialysisLeft ventricular massMore frequent hemodialysisPhysical health component scoreVitamin C

Identifiers

PMID31101018
PMCPMC6525383
OpenAlexW2947481266

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.