Evidence map›Paper›PMID 32732854›Full record

ArticleTransplantation2020

Poor Outcomes in Kidney Transplant Candidates and Recipients With History of Falls.

Nadia M Chu, Zhan Shi, Rachel Berkowitz, Christine E Haugen, Jacqueline Garonzik-Wang, Silas P Norman, Casey Humbyrd, Dorry L Segev, Mara A McAdams-DeMarco

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 36% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. The Impact of Falls: A Qualitative Study of the Experiences of People Receiving Haemodialysis.International journal of environmental research and public health · 2022
    Article
  6. Article
  7. 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

9 authors at 3 institutions in 1 country.

Nadia M ChuDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Zhan ShiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Rachel BerkowitzDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Christine E HaugenDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Jacqueline Garonzik-WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Silas P NormanDepartment of Internal Medicine, Division of Nephrology, University of Michigan School of Medicine, Ann Arbor, MI.
Casey HumbyrdDepartment of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Dorry L SegevDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Mara A McAdams-DeMarcoDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins University · USJohns Hopkins Medicine · USMichigan Medicine · US

Funding

Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
Hemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Aggressive Center Report Cards to Safely Increase Transplantation of Suboptimal KidneysK23DK115908 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI GARONZIK WANG, JACQUELINE M · 2018 to 2021
$516k
Frailty, Post-Transplant Delirium, and Neurocognitive Underpinnings of AlzheimersK01AG064040 · NIA · JOHNS HOPKINS UNIVERSITY · PI CHU, NADIA MIKHAIL · 2020 to 2022
$390k
Novel Frailty Phenotype in Older Adults with End-Stage Renal DiseaseF32AG053025 · NIA · JOHNS HOPKINS UNIVERSITY · PI HAUGEN, CHRISTINE · 2016 to 2019
$204k
NIAID NIH HHS K24 AI144954NIA NIH HHS F32 AG053025NIA NIH HHS K01 AG064040NIA NIH HHS R01 AG055781NIDDK NIH HHS K23 DK115908NIDDK NIH HHS K24 DK101828NIDDK NIH HHS R01 DK114074
6 · The paper itself

Abstract

backgroundFalls occur in 28% of hemodialysis patients and increase the risk of physical impairment, morbidity, and mortality. Therefore, it is likely that kidney transplantation (KT) candidates with recurrent falls are less likely to access KT and more likely to experience adverse post-KT outcomes.

methodsWe used a 2-center cohort study of KT candidates (n = 3666) and recipients (n = 770) (January 2009 to January 2018). Among candidates, we estimated time to listing, waitlist mortality, and transplant rate by recurrent falls (≥2 falls) before evaluation using adjusted regression. Among KT recipients, we estimated risk of mortality, graft loss, and length of stay by recurrent falls before KT using adjusted regression.

resultsCandidates with recurrent falls (6.5%) had a lower chance of listing (adjusted hazard ratio [aHR] = 0.68, 95% confidence interval [CI], 0.56-0.83) but not transplant rate; waitlist mortality was 31-fold (95% CI, 11.33-85.93) higher in the first year and gradually decreased over time. Recipients with recurrent falls (5.1%) were at increased risk of mortality (aHR = 51.43, 95% CI, 16.00-165.43) and graft loss (aHR = 33.57, 95% CI, 11.25-100.21) in the first year, which declined over time, and a longer length of stay (adjusted relative ratio [aRR] = 1.13, 95% CI, 1.03-1.25). In summary, 6.5% of KT candidates and 5.1% of recipients experienced recurrent falls which were associated with adverse pre- and post-KT outcomes.

conclusionsWhile recurrent falls were relatively rare in KT candidates and recipients, they were associated with adverse outcomes. Transplant centers should consider employing fall prevention strategies for high-risk candidates as part of comprehensive prehabilitation.

Indexed as

Accidental FallsAdultAgedFemaleFollow-Up StudiesGraft RejectionGraft SurvivalHumansKidney Failure, ChronicKidney TransplantationLength of StayLongitudinal StudiesMaleMiddle AgedPreoperative CareProspective Studies

Identifiers

PMID32732854
PMCPMC7237294
OpenAlexW2996042087

What OpenQuestion holds

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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.