Evidence map›Paper›PMID 31247182›Full record

ArticleThe American journal of medicine2020

Relation of Kidney Function Decline and NT-proBNP With Risk of Mortality and Readmission in Acute Decompensated Heart Failure.

Wendy McCallum, Hocine Tighiouart, Michael S Kiernan, Gordon S Huggins, Mark J Sarnak

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 7% 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

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.

  1. Guideline
  2. Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022
    Trial
  3. Trial
  4. Review
  5. Article
  6. Review
  7. Review
  8. Article
  9. Article
  10. Review
  11. Review
  12. New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy.International journal of molecular sciences · 2023
    Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Wendy McCallumDivision of Nephrology, Tufts Medical Center, Boston, Mass.
Hocine TighiouartInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Mass; Tufts Clinical and Translational Science Institute, Tufts University, Boston, Mass.
Michael S KiernanDivision of Cardiology, Tufts Medical Center, Boston, Mass.
Gordon S HugginsDivision of Cardiology, Tufts Medical Center, Boston, Mass.
Mark J SarnakDivision of Nephrology, Tufts Medical Center, Boston, Mass. Electronic address: msarnak@tuftsmedicalcenter.org.
Tufts Medical Center · US

Funding

Epidemiology, Clinical Trials and Outcomes Research In NephrologyT32DK007777 · NIDDK · TUFTS MEDICAL CENTER · PI SARNAK, MARK J · 1999 to 2020
$4.1M
NIDDK NIH HHS T32 DK007777
6 · The paper itself

Abstract

backgroundAcute declines in kidney function occur in approximately 20%-30% of patients with acute decompensated heart failure, but its significance is unclear, and the importance of its context is not known. This study aimed to determine the prognostic value of a decline in kidney function in the context of decongestion among patients admitted with acute decompensated heart failure.

methodsUsing data from patients enrolled in the Ultrafiltration in Decompensated Heart Failure with Cardiorenal Syndrome Study (CARRESS) and Diuretic Optimization Strategies Evaluation (DOSE) trials, we used multivariable Cox regression models to evaluate the association between decline in estimated glomerular filtration rate (eGFR) and change in N-terminal pro-b-type natriuretic peptide (NT-proBNP) with a composite outcome of death and rehospitalization, as well as testing for an interaction between the two.

resultsAmong 435 patients, in-hospital decline in eGFR was not significantly associated with death and rehospitalization (hazard ratio [HR] = 0.89 per 30% decline, 95% confidence interval [CI] 0.74, 1.07), whereas decline in NT-proBNP was associated with lower risk (HR = 0.69 per halving, 95% CI 0.58, 0.83). There was a significant interaction (P = 0.002 unadjusted; P = 0.03 adjusted) between decline in eGFR and change in NT-proBNP where a decline in eGFR was associated with better outcomes when NT-proBNP declined (HR = 0.78 per 30% decline in eGFR, 95% CI 0.61, 0.99), but not when NT-proBNP increased (HR = 0.99, 95% CI 0.76, 1.30).

conclusionsDecline in kidney function during therapy for acute decompensated heart failure is associated with improved outcomes as long as NT-proBNP levels are decreasing as well, suggesting that incorporation of congestion biomarkers may aid clinical interpretation of eGFR declines.

Indexed as

Glomerular Filtration RateMortalityAcute DiseaseAgedAged, 80 and overCardio-Renal SyndromeFemaleHeart FailureHumansKidneyMaleMiddle AgedNatriuretic Peptide, BrainPatient ReadmissionPeptide FragmentsPrognosisNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Acute decompensated heart failureCardiorenal syndromeDecline in kidney functionDecongestion

Identifiers

PMID31247182
PMCPMC7373496
OpenAlexW2952710722

What OpenQuestion holds

Textmetadata
LicenceTDM
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.