Evidence map›Paper›PMID 31943084›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2021

Kidney function and symptom development over time in elderly patients with advanced chronic kidney disease: results of the EQUAL cohort study.

Cynthia J Janmaat, Merel van Diepen, Yvette Meuleman, Nicholas C Chesnaye, Christiane Drechsler, Claudia Torino, Christoph Wanner, Maurizio Postorino, Maciej Szymczak, Marie Evans and 4 more

Open access · bronzeAbstract read
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Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.2field-weighted citation impact, top 12% 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, 27 citations in OpenAlex.

  1. The evolution of symptom burden in older men and women with advanced CKD.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Observational
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  5. Review
  6. Observational
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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

14 authors at 8 institutions in 6 countries.

Cynthia J JanmaatDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Merel van DiepenDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Yvette MeulemanDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Nicholas C ChesnayeDepartment of Medical Informatics, Academic Medical Center, ERA-EDTA Registry, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Christiane DrechslerDepartment of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
Claudia TorinoCNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
Christoph WannerDepartment of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
Maurizio PostorinoNephrology Dialysis and Transplant Unit Grande Ospedale Metropolitano, Reggio Calabria, Italy.
Maciej SzymczakDepartment of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Marie EvansDepartment of Clinical Sciences Intervention and Technology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Fergus J CaskeyUK Renal Registry, Southmead Hospital, Bristol, UK.
Kitty J JagerDepartment of Medical Informatics, Academic Medical Center, ERA-EDTA Registry, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Friedo W DekkerDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
EQUAL Study Investigators
Leiden University Medical Center · NLAmsterdam UMC Location University of Amsterdam · NLUniversitätsklinikum Würzburg · DEIstituto di Fisiologia Clinica · ITKarolinska University Hospital · SEOspedale Maggiore · ITSouthmead Hospital · GBWroclaw Medical University · PL

Funding

Department of Health
6 · The paper itself

Abstract

backgroundInitiation of renal replacement therapy often results from a combination of kidney function deterioration and symptoms related to chronic kidney disease (CKD) progression. We investigated the association between kidney function decline and symptom development in patients with advanced CKD.

methodsIn the European Quality study on treatment in advanced CKD (EQUAL study), a European prospective cohort study, patients with advanced CKD aged ≥65 years and a kidney function that dropped <20 mL/min/1.73 m2 were followed for 1 year. Linear mixed-effects models were used to assess the association between kidney function decline and symptom development. The sum score for symptom number ranged from 0 to 33 and for overall symptom severity from 0 to 165, using the Dialysis Symptom Index.

resultsAt least one kidney function estimate with symptom number or overall symptom severity was available for 1109 and 1019 patients, respectively. The mean (95% confidence interval) annual kidney function decline was 1.70 (1.32; 2.08) mL/min/1.73 m2. The mean overall increase in symptom number and severity was 0.73 (0.28; 1.19) and 2.93 (1.34; 4.52) per year, respectively. A cross-sectional association between the level of kidney function and symptoms was lacking. Furthermore, kidney function at cohort entry was not associated with symptom development. However, each mL/min/1.73 m2 of annual kidney function decline was associated with an extra annual increase of 0.23 (0.07; 0.39) in the number of symptoms and 0.87 (0.35; 1.40) in overall symptom severity.

conclusionsA faster kidney function decline was associated with a steeper increase in both symptom number and severity. Considering the modest association, our results seem to suggest that repeated thorough assessment of symptom development during outpatient clinic visits, in addition to the monitoring of kidney function decline, is important for clinical decision-making.

Indexed as

Glomerular Filtration RateAgedCohort StudiesCross-Sectional StudiesDisease ProgressionHumansKidneyProspective StudiesRenal DialysisRenal Insufficiency, ChronicRenal Replacement Therapychronic kidney diseaseclinical epidemiologykidney functionkidney function declinesymptoms

Identifiers

PMID31943084
PMCPMC8075370
OpenAlexW2999650249

What OpenQuestion holds

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LicenceCC BY-NC
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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.