Evidence map›Paper›PMID 32410664›Full record

Observational studyBMC nephrology2020

Benefits of peritoneal ultrafiltration in HFpEF and HFrEF patients.

Leonie Grossekettler, Bastian Schmack, Carsten Brockmann, Reinhard Wanninger, Michael M Kreusser, Lutz Frankenstein, Lars P Kihm, Martin Zeier, Hugo A Katus, Vedat Schwenger and 1 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

9 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Review
  6. Review
  7. Article
  8. Review
  9. 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

11 authors.

Leonie GrossekettlerDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. leonie.grossekettler@med.uni-heidelberg.de.
Bastian SchmackClinic for Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Germany.
Carsten BrockmannClinic for Cardiology, Heart and Vascular Center, Bad Bevensen, Germany.
Reinhard WanningerDepartment of Nephrology, Medical Center, Bad Bevensen, Germany.
Michael M KreusserDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Lutz FrankensteinDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Lars P KihmDepartment of Nephrology, Clinic Braunschweig, Braunschweig, Germany.
Martin ZeierDepartment of Nephrology, Clinic Braunschweig, Braunschweig, Germany.
Hugo A KatusDepartment of Internal Medicine III, Cardiology, Angiology and Pulmonology, University Hospital of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
Vedat SchwengerDepartment of Nephrology, Clinic Braunschweig, Braunschweig, Germany.
Andrew RemppisDepartment of Kidney-, Blood Pressure- and Autoimmune Diseases, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany.

Funding

Deutsche Gesellschaft für Nephrologie na
6 · The paper itself

Abstract

backgroundPeritoneal ultrafiltration (pUF) in refractory heart failure (HF) reduces the incidence of decompensation episodes, which is of particular significance as each episode incrementally adds to mortality. Nevertheless, there are insufficient data about which patient cohort benefits the most. The objective of this study was to compare pUF in HFrEF and HFpEF, focusing on functional status, hospitalizations, surrogate endpoints and mortality.

methodsThis study involves 143 patients, who could be classified as either HFpEF (n = 37, 25.9%) or HFrEF (n = 106, 74.1%) and who received pUF due to refractory HF.

resultsBaseline eGFR was similar in HFrEF (23.1 ± 10.6 mg/dl) and HFpEF (27.8 ± 13.2 mg/dl). Significant improvements in NYHA class were found in HFpEF (3.19 ± 0.61 to 2.72 ± 0.58, P <  0.001) and HFrEF (3.45 ± 0.52 to 2.71 ± 0.72, P <  0.001). CRP decreased in HFrEF (19.4 ± 17.6 mg/l to 13.7 ± 21.4 mg/l, P = 0.018) and HFpEF (33.7 ± 52.6 mg/l to 17.1 ± 26.3 mg/l, P = 0.004). Body weight was significantly reduced in HFrEF (81.1 ± 14.6 kg to 77.2 ± 15.6 kg, P = 0.003) and HFpEF (86.9 ± 15.8 kg to 83.1 ± 15.9 kg, P = 0.005). LVEF improved only in HFrEF (25.9 ± 6.82% to 30.4 ± 12.2%, P = 0.046). BCR decreased significantly in HFrEF and HFpEF (55.7 ± 21.9 to 34.3 ± 17.9 P > 0.001 and 50.5 ± 68.9 to 37.6 ± 21.9, P = 0.006). Number of hospitalization episodes as well as number of hospitalization days decreased significantly only in HFpEF (total number 2.88 ± 1.62 to 1.25 ± 1.45, P <  0.001, days 40.4 ± 31.7 to 18.3 ± 22.5 days, P = 0.005).

conclusionspUF offers various benefits in HFpEF and HFrEF, but there are also substantial differences. In particular, hospitalization rates were found to be significantly reduced in HFpEF patients, indicating a greater medical and economical advantage. However, LVEF was only found to be improved in HFrEF patients. While pUF can now be regarded as an option to supplement classical HF therapy, further studies are desirable to obtain specifications about pUF in HFpEF, HFmEF and HFrEF patients.

Indexed as

Stroke VolumeDiureticsFemaleHeart FailureHemodiafiltrationHemofiltrationHospitalizationHumansMaleMineralocorticoid Receptor AntagonistsPeritoneal DialysisPeritoneal Dialysis, Continuous AmbulatoryTreatment OutcomeWater-Electrolyte ImbalanceDiureticsMineralocorticoid Receptor AntagonistsCardiorenal syndromeHeart failureHFpEFHFrEFPeritoneal dialysisUltrafiltration

Identifiers

PMID32410664
PMCPMC7222460

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Registered trials

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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.