Evidence map›Paper›PMID 32111190›Full record

ArticleBMC nephrology2020

Exclusion of pregnancy in dialysis patients: diagnostic performance of human chorionic gonadotropin.

Natalja Haninger-Vacariu, Harald Herkner, Matthias Lorenz, Marcus Säemann, Andreas Vychytil, Martin Jansen, Rodrig Marculescu, Reinhard Kramar, Gere Sunder-Plassmann, Alice Schmidt

Open access · goldAbstract read
In one paragraph

Article in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 19% 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

4 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. End-Stage Kidney Disease and Dialysis in Pregnancy.Advances in chronic kidney disease · 2020
    Review
  4. Review
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

10 authors at 4 institutions in 1 country.

Natalja Haninger-VacariuDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria. natalja.haninger-vacariu@meduniwien.ac.at.ORCID 0000-0001-6323-1007
Harald HerknerDepartment of Emergency Medicine, Medical University of Vienna, 1090, Vienna, Austria.
Matthias LorenzDialysis Centre Vienna, 1220, Vienna, Austria.
Marcus SäemannDepartment of Medicine VI, Wilhelminenspital, 1160, Vienna, Austria.
Andreas VychytilDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
Martin JansenDivision of Gastroenterology and Nephrology, Department of Medicine I, Hospital St. John of God, 1020, Vienna, Austria.
Rodrig MarculescuDepartment of Laboratory Medicine, Medical University of Vienna, 1090, Vienna, Austria.
Reinhard KramarAustrian Dialysis and Transplant Registry, 4532, Rohr im Kremstal, Austria.
Gere Sunder-PlassmannDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
Alice SchmidtDivision of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
Medical University of Vienna · ATHospital of the Brothers of St. John of God · ATSigmund Freud Privatuniversität Wien · ATStatistics Austria · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA positive pregnancy test in acute or chronically ill patients has implications for the use of potentially mutagenic or teratogenic products in urgent medical therapies such as the use of chemotherapies or therapies with immunosuppressants, for anesthesia, and for time-sensitive indications like urgent surgery or organ Transplantation. Despite a lack of evidence, it is currently believed that human chorionic gonadotropin serum concentrations are always elevated in female dialysis patients even without pregnancy. It is also believed that human chorionic gonadotropin cannot be used to confirm or exclude pregnancy.

methodsHuman chorionic gonadotropin was examined in female dialysis patients (18-50 years of age), and was classified as positive above 5 mlU/ml. In addition, fertility status was determined. For an enhanced index test, the cut-off of 5 mIU/ml was used for potentially fertile patients and 14 mIU/ml for infertile patients to calculate diagnostic test accuracy. The ideal cut-off for human chorionic gonadotropin was estimated using Liu's method with bootstrapped 95% confidence intervals. Predictors of human chorionic gonadotropin increase were analyzed using multivariable linear regression.

resultsAmong 71 women, two (2.8%) were pregnant, 46 (64.8%) potentially fertile, and 23 (32.4%) infertile. We observed human chorionic gonadotropin concentrations > 5 mIU/ml in 10 patients, which had a sensitivity of 100% (95% confidence interval: 100 to 100), a specificity of 86% (95% confidence interval: 77 to 94), a positive predictive value of 17% (95% confidence interval: 8 to 25) and a negative predictive value of 100% (95% confidence interval: 100 to 100) for the diagnosis of pregnancy. Using a cut-off > 14 mIU/ml for infertile patients or the exclusion of infertile patients increased specificity to 93% or 98%, respectively. The ideal cut-off was 25 mIU/ml (95% confidence interval: 17 to 33). Pregnancy and potential fertility, but not age, were independent predictors of human chorionic gonadotropin.

conclusionHuman chorionic gonadotropin is elevated > 5mIU/ml in 14.5% of non-pregnant dialysis patients of child-bearing age. In potentially fertile women, this cut-off can be used to exclude pregnancy. In case of an unknown fertility status, the ideal human chorionic gonadotropin cut-off was 25 mIU/ml.

Indexed as

Renal DialysisAdolescentAdultChorionic GonadotropinFemaleHumansInfertility, FemaleMiddle AgedPregnancyReference ValuesRenal Insufficiency, ChronicYoung AdultChorionic GonadotropinAnesthesiaAnti-Müllerian hormoneChronic kidney diseaseDiagnostic accuracyDialysisFertilityFollicle stimulating hormoneHuman chorionic gonadotropinImmunosuppressantKidney transplantationMenopauseMenstrual cyclePregnancySurgery

Identifiers

PMID32111190
PMCPMC7049197
OpenAlexW3012097526

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.