Evidence map›Paper›PMID 32003794›Full record

Observational studyNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2020

Association of all-cause mortality with pre-dialysis systolic blood pressure and its peridialytic change in chronic hemodialysis patients.

Hanjie Zhang, Priscila Preciado, Yuedong Wang, Anna Meyring-Wosten, Jochen G Raimann, Jeroen P Kooman, Frank M van der Sande, Len A Usvyat, Dugan Maddux, Franklin W Maddux and 1 more

Open access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 18% 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

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Observational
  8. Observational
  9. Review
  10. Article
  11. Long-term peridialytic blood pressure changes are related to mortality.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
    Article
  12. Observational
  13. The associations between orthostatic blood pressure changes and extracellular volume in hemodialysis patients.Hemodialysis international. International Symposium on Home Hemodialysis · 2022
    Article
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Hanjie ZhangResearch Department, Renal Research Institute, New York, NY, USA.
Priscila PreciadoResearch Department, Renal Research Institute, New York, NY, USA.
Yuedong WangDepartment of Statistics and Applied Probability, University of California at Santa Barbara, CA, USA.
Anna Meyring-WostenResearch Department, Renal Research Institute, New York, NY, USA.
Jochen G RaimannResearch Department, Renal Research Institute, New York, NY, USA.
Jeroen P KoomanDivision of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Frank M van der SandeDivision of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Len A UsvyatFresenius Medical Care, Waltham, MA, USA.
Dugan MadduxFresenius Medical Care, Waltham, MA, USA.
Franklin W MadduxFresenius Medical Care, Waltham, MA, USA.
Peter KotankoResearch Department, Renal Research Institute, New York, NY, USA.
Renal Research Institute · USFresenius Medical Care (United States) · USMaastricht University · NLUniversity of California, Santa Barbara · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPre-dialysis systolic blood pressure (pre-HD SBP) and peridialytic SBP change have been associated with morbidity and mortality among hemodialysis (HD) patients in previous studies, but the nature of their interaction is not well understood.

methodsWe analyzed pre-HD SBP and peridialytic SBP change (calculated as post-HD SBP minus pre-HD SBP) between January 2001 and December 2012 in HD patients treated in US Fresenius Medical Care facilities. The baseline period was defined as Months 4-6 after HD initiation, and all-cause mortality was noted during follow-up. Only patients who survived baseline and had no missing covariates were included. Censoring events were renal transplantation, modality change or study end. We fitted a Cox proportional hazard model with a bivariate spline functions for the primary predictors (pre-HD SBP and peridialytic SBP change) with adjustment for age, gender, race, diabetes, access-type, relative interdialytic weight gain, body mass index, albumin, equilibrated normalized protein catabolic rate and ultrafiltration rate.

resultsA total of 172 199 patients were included. Mean age was 62.1 years, 61.6% were white and 55% were male. During a median follow-up of 25.0 months, 73 529 patients (42.7%) died. We found that a peridialytic SBP rise combined with high pre-HD SBP was associated with higher mortality. In contrast, when concurrent with low pre-HD SBP, a peridialytic SBP rise was associated with better survival.

conclusionThe association of pre-HD and peridialytic SBP change with mortality is complex. Our findings call for a joint, not isolated, interpretation of pre-HD SBP and peridialytic SBP change.

Indexed as

Blood PressureWeight GainAdultAgedFemaleHumansHypertensionKidney Failure, ChronicMaleMortalityPrognosisRenal DialysisSurvival Ratechronic hemodialysismortalityperidialytic systolic blood pressurepre-hemodialysis systolic blood pressure

Identifiers

PMID32003794
PMCPMC7473807
OpenAlexW3003708930

What OpenQuestion holds

Textmetadata
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.