Evidence map›Paper›PMID 31668375›Full record

Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2020

Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study.

Tamara Isakova, Xuan Cai, Jungwha Lee, Rupal Mehta, Xiaoming Zhang, Wei Yang, Lisa Nessel, Amanda Hyre Anderson, Joan Lo, Anna Porter and 11 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06795698 (The Effect of Prophylactic Anticoagulation on Major Bleeding Events in Hospitalized Chronic Kidney Disease and Lower Limb Fracture Patients. a Phase 2, Randomized, Doble Blind, Control Trial), which is not on this map. Cited by 47 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 1 pooled it
5.4field-weighted citation impact, top 3% 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.

NCT06795698 phase2completednot on this map

The Effect of Prophylactic Anticoagulation on Major Bleeding Events in Hospitalized Chronic Kidney Disease and Lower Limb Fracture Patients. a Phase 2, Randomized, Doble Blind, Control Trial

TypeinterventionalSponsorHospital Civil de GuadalajaraRan2019 to 2024Enrolled61ConditionsFractures, Bone, CKD Stage 4, CKD Stage 3, CKD Stage 5ArmsEnoxaparin
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Systemic versus local regulation of vitamin D.Current opinion in nephrology and hypertension · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. ASN Kidney Health Guidance on Potassium and Phosphorus Food Additives.Journal of the American Society of Nephrology : JASN · 2025
    Article
  11. Article
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Emerging concepts on the FGF23 regulation and activity.Molecular and cellular biochemistry · 2025
    Review
  18. Review
  19. Risk factors for hip and vertebral fractures in chronic kidney disease: the CRIC study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024
    Article
  20. 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

21 authors at 12 institutions in 1 country.

Tamara IsakovaDivision of Nephrology and Hypertension, Department of Medicine, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: tamara.isakova@northwestern.edu.
Xuan CaiCenter for Translational Metabolism and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Jungwha LeeCenter for Translational Metabolism and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Rupal MehtaDivision of Nephrology and Hypertension, Department of Medicine, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; Jesse Brown Veterans Administration Medical Center, Chicago, IL.
Xiaoming ZhangCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Wei YangCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Lisa NesselCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Amanda Hyre AndersonSection of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Joan LoKaiser Permanente, Oakland, CA.
Anna PorterSection of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine Chicago, IL.
Julie Wright NunesDivision of Nephrology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Lavinia NegreaDivision of Nephrology and Hypertension, Department of Medicine, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
Lee HammSection of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Edward HorwitzDivision of Nephrology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
Jing ChenSection of Nephrology and Hypertension, Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
Julia J SciallaDivision of Nephrology, Department of Medicine, and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
Ian H de BoerDivision of Nephrology, Department of Medicine, University of Washington, Seattle, WA.
Mary B LeonardDepartment of Pediatrics, Stanford University, Stanford, CA; Department of Medicine, Stanford University, Stanford, CA.
Harold I FeldmanJesse Brown Veterans Administration Medical Center, Chicago, IL; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Myles WolfDivision of Nephrology, Department of Medicine, and Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
CRIC Study Investigators
Tulane University · USUniversity of Pennsylvania · USNorthwestern University · USClinical Research Institute · USCase Western Reserve University · USJesse Brown VA Medical Center · USKaiser Permanente · USMetroHealth Medical Center · USMichigan Medicine · USStanford University · USUniversity of Illinois Chicago · USUniversity of Washington · US

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
Tracking & Evaluation CoreU54GM104940 · NIGMS · LSU PENNINGTON BIOMEDICAL RESEARCH CTR · PI Peter Todd Katzmarzyk · 2012 to 2026
$69.1M
Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Scientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Strengthening Stakeholder Engagement in Human Research Protections.UL1TR002003 · NCATS · UNIVERSITY OF ILLINOIS AT CHICAGO · PI KARNIK, NIRANJAN SUBHASH, MERMELSTEIN, ROBIN J. · 2016 to 2024
$33.7M
Tulane COBRE in Cardiometabolic Diseases Clinical Research CoreP20GM109036 · NIGMS · TULANE UNIVERSITY OF LOUISIANA · PI JING CHEN · 2016 to 2026
$25.3M
Continuation of the Coordinating Center for the Chronic Renal Insufficiency Cohort (CRIC) StudyU24DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI Amanda Hyre Anderson, Laura M Dember · 2018 to 2026
$21.5M
Zonulin Antibodies in Intestinal Permeabilitiy in IDDMM01RR016500 · NCRR · UNIVERSITY OF MARYLAND BALTIMORE · PI OSWALD, LYNN M · 2002 to 2009
$20.2M
NCATS NIH HHS KL2 TR001424NCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1 TR000424NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1 TR001422NCATS NIH HHS UL1 TR002003NCATS NIH HHS UL1 TR002548NCRR NIH HHS M01 RR013987NCRR NIH HHS M01 RR016500NCRR NIH HHS UL1 RR024131NCRR NIH HHS UL1 RR029879NIDDK NIH HHS K23 DK097183NIDDK NIH HHS K24 DK093723NIDDK NIH HHS P30 DK114857NIDDK NIH HHS R01 DK072231NIDDK NIH HHS R01 DK076116NIDDK NIH HHS R01 DK081374NIDDK NIH HHS R01 DK094796NIDDK NIH HHS R01 DK099199NIDDK NIH HHS R01 DK102438NIDDK NIH HHS R01 DK110087NIDDK NIH HHS R01 DK111952NIDDK NIH HHS R01 DK139225NIDDK NIH HHS U01 DK060902NIDDK NIH HHS U01 DK060963NIDDK NIH HHS U01 DK060980NIDDK NIH HHS U01 DK060984NIDDK NIH HHS U01 DK060990NIDDK NIH HHS U01 DK061021NIDDK NIH HHS U01 DK061022NIDDK NIH HHS U01 DK061028NIDDK NIH HHS U01 DK099930NIDDK NIH HHS U24 DK060990NIGMS NIH HHS P20 GM109036NIGMS NIH HHS U54 GM104940
6 · The paper itself

Abstract

RATIONALE &

objectiveThe pathogenesis of disordered mineral metabolism in chronic kidney disease (CKD) is largely informed by cross-sectional studies of humans and longitudinal animal studies. We sought to characterize the longitudinal evolution of disordered mineral metabolism during the course of CKD. STUDY

designRetrospective analysis nested in a cohort study. SETTING &

participantsParticipants in the Chronic Renal Insufficiency Cohort (CRIC) Study who had up to 5 serial annual measurements of estimated glomerular filtration rate, fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), serum phosphate, and serum calcium and who subsequently reached end-stage kidney disease (ESKD) during follow-up (n = 847). EXPOSURE: Years before ESKD. OUTCOMES: Serial FGF-23, PTH, serum phosphate, and serum calcium levels. ANALYTICAL APPROACH: To assess longitudinal dynamics of disordered mineral metabolism in human CKD, we used "ESKD-anchored longitudinal analyses" to express time as years before ESKD, enabling assessments of mineral metabolites spanning 8 years of CKD progression before ESKD.

resultsMean FGF-23 levels increased markedly as time before ESKD decreased, while PTH and phosphate levels increased modestly and calcium levels declined minimally. Compared with other mineral metabolites, FGF-23 levels demonstrated the highest rate of change (velocity: first derivative of the function of concentration over time) and magnitude of acceleration (second derivative). These changes became evident approximately 5 years before ESKD and persisted without deceleration through ESKD onset. Rates of changes in PTH and phosphate levels increased modestly and without marked acceleration around the same time, with modest deceleration immediately before ESKD, when use of active vitamin D and phosphate binders increased. LIMITATIONS: Individuals who entered the CRIC Study at early stages of CKD and who did not progress to ESKD were not studied.

conclusionsAmong patients with progressive CKD, FGF-23 levels begin to increase 5 years before ESKD and continue to rapidly accelerate until transition to ESKD.

Indexed as

AdultAgedBiomarkersBone DensityCalciumCross-Sectional StudiesDisease ProgressionFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsFollow-Up StudiesHumansMaleMiddle AgedMineralsParathyroid HormoneBiomarkersCalciumFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsMineralsParathyroid HormonePhosphatesbiomarkercalciumChronic kidney disease (CKD)CKD progressiondisordered mineral metabolismend-stage renal disease (ESRD)fibroblast growth factor 23 (FGF-23)incident kidney failurekidney functionlongitudinal trendsparathyroid hormone (PTH)phosphateserial measurements

Identifiers

PMID31668375
PMCPMC7012684
OpenAlexW2982064585

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Registered trials

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.