Evidence map›Paper›PMID 32775980›Full record

ArticleKidney medicine

Estimated GFR Trajectories in Pediatric and Adult Nephrotic Syndrome: Results From the Nephrotic Syndrome Study Network (NEPTUNE).

Abigail R Smith, Jarcy Zee, Nan Ji, Jonathan P Troost, Brenda W Gillespie, Viji Nair, Qian Liu, Keisha L Gibson, Matthias Kretzler, Laura H Mariani

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 50% 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

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

  1. Pooled it
  2. Article
  3. 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

10 authors at 3 institutions in 1 country.

Abigail R SmithArbor Research Collaborative for Health, Ann Arbor, MI.
Jarcy ZeeArbor Research Collaborative for Health, Ann Arbor, MI.
Nan JiArbor Research Collaborative for Health, Ann Arbor, MI.
Jonathan P TroostMichigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI.
Brenda W GillespieDepartment of Biostatistics, University of Michigan, Ann Arbor, MI.
Viji NairDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Qian LiuArbor Research Collaborative for Health, Ann Arbor, MI.
Keisha L GibsonDivision of Pediatric Nephrology, Department of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC.
Matthias KretzlerDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Laura H MarianiDivision of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
University of Michigan–Ann Arbor · USArbor Research Collaborative for Health · USUniversity of North Carolina at Chapel Hill · US

Funding

Integrative Molecular Epidemiology Approach to Identify Nephrotic Syndrome SubgroupsK08DK115891 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARIANI, LAURA H · 2018 to 2021
$678k
NIDDK NIH HHS K08 DK115891
6 · The paper itself

Abstract

RATIONALE &

objectiveSurrogate outcomes for end-stage kidney disease often assume linear changes, which may not reflect true estimated glomerular filtration rate (eGFR) trajectories. This study's objective was to characterize nonlinear eGFR trajectories in nephrotic syndrome. STUDY

designObservational cohort study. SETTING &

participantsNephrotic Syndrome Study Network (NEPTUNE) is a multicenter study of adult and pediatric patients with proteinuria enrolled at clinically indicated kidney biopsy or initial presentation of disease (pediatric only). PREDICTORS: Patient demographic, clinical, and pathology variables at study enrollment and follow-up time. OUTCOME: eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (patients ≥ 18 years old) or modified Chronic Kidney Disease in Children Study-Schwartz (patients < 18 years) formulas. The probability of nonlinearity (PNL) was calculated for individual eGFR trajectories. ANALYTICAL APPROACH: Associations between predictors and PNL were assessed using multivariable linear regression.

results453 patients with ≥3 eGFR measurements and 1 or more year of follow-up were included (median follow-up, 3.6 years). Median PNL was 0.052; 56% and 16% had PNL < 10% and >50%, respectively. In both adults and pediatric patients, higher baseline eGFR was associated with higher PNL, whereas longer follow-up time was associated with lower PNL. Higher urine protein-creatinine ratio and steroid use were also associated with higher PNL in adults. Higher percentages of tubular atrophy and foot-process effacement were associated with lower and higher PNLs, respectively, in adults. LIMITATIONS: Relatively short follow-up time, inability to assess acute kidney injury events, and variable eGFR measurement frequency across patients.

conclusionsAlthough increasing follow-up time resulted in more linear trajectories, nonlinear eGFR trajectories were common in this cohort. Future studies in nephrotic syndrome should consider novel outcomes that do not rely on linearity assumptions.

Indexed as

ESKDGlomerular diseasenon-linear eGFRsurrogate outcomes

Identifiers

PMID32775980
PMCPMC7406843
OpenAlexW3033462639

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.