Evidence map›Paper›PMID 32800842›Full record

Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2021

Treating Home Versus Predialysis Blood Pressure Among In-Center Hemodialysis Patients: A Pilot Randomized Trial.

Nisha Bansal, David V Glidden, Rajnish Mehrotra, Raymond R Townsend, Jordana Cohen, Lori Linke, Farshad Palad, Hannah Larson, Chi-Yuan Hsu

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03459807 (BOLD), which is not on this map. Cited by 16 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 4 pooled it
1.1field-weighted citation impact, top 22% 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.

NCT03459807 phase2completednot on this map

BOLD: A Trial of Blood Pressure Lowering in Dialysis

TypeinterventionalSponsorUniversity of California, San FranciscoRan2018 to 2018Enrolled50ConditionsBlood Pressure, End Stage Renal Disease on Dialysis (Diagnosis), Chronic Kidney Diseases, Chronic Kidney Disease Stage 5ArmsAnti-Hypertensive medications, Dry Weight Adjustment
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Interventions for fatigue in people with kidney failure requiring dialysis.The Cochrane database of systematic reviews · 2023
    Pooled it
  4. Guideline
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Review
  10. A Qualitative Study of Nephrologists' Perceptions of Management of Hypertension in Hemodialysis Patients.Clinical journal of the American Society of Nephrology : CJASN · 2026
    Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Comparison of Dialysis Unit and Home Blood Pressures: An Observational Cohort Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2021
    Observational
  16. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Nisha BansalDivision of Nephrology, Kidney Research Institute, University of Washington, Seattle, WA. Electronic address: nbansal@nephrology.washington.edu.
David V GliddenDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
Rajnish MehrotraDepartment of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
Raymond R TownsendDivision of Nephrology, University of Pennsylvania, Philadelphia, PA.
Jordana CohenDivision of Nephrology, University of Pennsylvania, Philadelphia, PA.
Lori LinkeDivision of Nephrology, Kidney Research Institute, University of Washington, Seattle, WA.
Farshad PaladDivision of Nephrology, University of California, San Francisco, San Francisco, CA.
Hannah LarsonDivision of Nephrology, Kidney Research Institute, University of Washington, Seattle, WA.
Chi-Yuan HsuDivision of Nephrology, University of California, San Francisco, San Francisco, CA.
University of California, San Francisco · USUniversity of Washington · USUniversity of Pennsylvania · US

Funding

Patient Oriented Research in Kidney DiseaseK24DK092291 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HSU, CHI-YUAN · 2011 to 2020
$1.2M
A pilot study to target out-of-dialysis-unit versus dialysis-unit blood pressureR21DK114213 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BANSAL, NISHA, HSU, CHI-YUAN · 2017 to 2018
$456k
NIDDK NIH HHS K24 DK092291NIDDK NIH HHS R21 DK114213
6 · The paper itself

Abstract

RATIONALE &

objectiveObservational studies have reported a U-shaped association between blood pressure (BP) before a hemodialysis session and death. In contrast, because a linear association between out-of-dialysis-unit BP and death has been reported, home BP may be a better target for treatment. To test the feasibility of this approach, we conducted a pilot trial of treating home versus predialysis BP in hemodialysis patients. STUDY

designA 4-month, parallel, randomized, controlled trial. SETTINGS &

participants50 prevalent hemodialysis patients in San Francisco and Seattle. Participants were randomly assigned using 1:1 block randomization, stratified by site.

interventionsTo target home systolic BP (SBP) of 100-<140 mm Hg versus predialysis SBP of 100-<140mm Hg. Home and predialysis SBPs were ascertained every 2 weeks. Dry weight and BP medications were adjusted to reach the target SBP. OUTCOMES: Primary outcomes were feasibility, adherence, safety. and tolerability.

results50 of 70 (71%) patients who were approached agreed to participate. All enrollees completed the study except for 1 who received a kidney transplant. In the home BP treatment group, adherence to obtaining/reporting home BP was 97.4% (and consistent over the 4 months). There was no increased frequency of high (defined as SBP>200mm Hg; 0.2% vs 0%) or low (defined as<90mm Hg; 1.8% vs 1.2%) predialysis BP readings in the home versus predialysis treatment arms, respectively. However, participants in the home BP arm had higher frequency of fatigue (32% vs 16%). LIMITATIONS: Small sample size.

conclusionsThis pilot trial demonstrates feasibility and high adherence to home BP measurement and treatment in hemodialysis patients. Larger trials to test the long-term feasibility, efficacy, and safety of home BP treatment in hemodialysis patients should be conducted. FUNDERS: National Institutes of Health, Satellite Healthcare, and Northwest Kidney Centers.

trial registrationRegistered at ClinicalTrials.gov with study number NCT03459807.

Indexed as

Kidney Failure, ChronicRenal DialysisAntihypertensive AgentsBlood PressureBlood Pressure DeterminationBlood Pressure Monitoring, AmbulatoryFemaleHome Care ServicesHumansMaleMiddle AgedOutcome and Process Assessment, Health CarePatient CompliancePilot ProjectsPrognosisRisk AssessmentAntihypertensive AgentsBlood pressure (BP)BP managementBP targetclinical trialdry weight adjustmentend-stage renal disease (ESRD)hemodialysishome BPhypertensionmasked hypertensionpilot studypragmatic trialwhite coat effect

Identifiers

PMID32800842
PMCPMC7752836
OpenAlexW3048657638

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.