Evidence map›Paper›PMID 32277424›Full record

ArticleJournal of nephrology2021

Reduced myocardial blood flow reserve in kidney transplant candidates may hamper risk stratification.

Majed Malak, Emily Christie, Kevin Wen, Haimanot Wasse, Morteza Hajihosseini, Padma Kaul, Paolo Raggi

Abstract read
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In one paragraph

Article in Journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.1field-weighted citation impact, top 52% 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

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

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

7 authors at 3 institutions in 2 countries.

Majed MalakDivision of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Emily ChristieDivision of Nephrology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Kevin WenDivision of Nephrology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Haimanot WasseDivision of Nephrology, Department of Medicine, Rush University Medical Center, Chicago, IL, USA.
Morteza HajihosseiniSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Padma KaulSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Paolo RaggiDivision of Cardiology, Department of Medicine, University of Alberta, 8440 112 Street, Suite 5A9-014, Edmonton, AB, T6G2B7, Canada. raggi@ualberta.ca.
University of Alberta · CAHarvard University · USRush University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVasodilator nuclear stress testing is frequently ordered for risk stratification prior to kidney transplantation. Since

methodsWe reviewed the MBF response to dipyridamole infusion in 328 patients with end-stage kidney disease (ESKD) prior to transplant (188 hemodialysis-HD, 120 peritoneal dialysis-PD, and 20 pre-dialysis patients-CKD5) and in 100 controls with normal kidney function. A stress/rest MBF ratio ≥ 2 was considered an adequate response to dipyridamole. Coronary artery calcium (CAC) was measured on CT.

resultsInadequate MBF response was seen in 36%-HD, 21%-PD, 45%-CKD5 vs. 23%-controls (p = 0.006). Univariable predictors of poor MBF response in ESKD patients were age, diabetes mellitus, and CAC (all p < 0.03) while serum hemoglobin was borderline significant (p = 0.052). Multivariable predictors of a poor MBF response were age (p = 0.002) and lower serum hemoglobin (p = 0.014). Ischemia was identified in 8% of ESKD patients and 24% of controls (p < 0.001).

conclusionsESKD patients are less likely to respond appropriately to vasodilator stress compared to patients with normal renal function and had a lower incidence of ischemia despite a high pre-test probability of disease. Physicians performing vasodilator stress without MBF measurement should be aware of the high probability of a false negative response.

Indexed as

Coronary Artery DiseaseKidney TransplantationCoronary CirculationCoronary VesselsDipyridamoleHumansRisk AssessmentDipyridamoleHemodialysisKidney transplantationMyocardial blood flowPositron emission tomographyRisk stratification

Identifiers

PMID32277424
OpenAlexW3015863609

What OpenQuestion holds

Textmetadata
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.