Evidence map›Paper›PMID 33148691›Full record

ArticleBMJ open diabetes research & care2020

Microscopic hematuria is a risk factor for end-stage kidney disease in patients with biopsy-proven diabetic nephropathy.

Sadanori Okada, Ken-Ichi Samejima, Masaru Matsui, Katsuhiko Morimoto, Riri Furuyama, Kaori Tanabe, Masahiro Eriguchi, Yasuhiro Akai, Yoshihiko Saito, Kazuhiko Tsuruya

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Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
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.

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, 14 citations in OpenAlex.

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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 2 institutions in 1 country.

Sadanori Okada *Center for Postgraduate Training, Nara Medical University, Kashihara, Nara, Japan.
Ken-Ichi Samejima *Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan ksame@naramed-u.ac.jp.ORCID 0000-0001-8273-5155
Masaru MatsuiDepartment of Nephrology, Nara Prefecture General Medical Center, Nara, Japan.
Katsuhiko MorimotoDepartment of Nephrology, Nara Prefecture Seiwa Medical Center, Nara, Japan.
Riri FuruyamaDepartment of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Kaori TanabeDepartment of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Masahiro EriguchiDepartment of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Yasuhiro AkaiCenter for Postgraduate Training, Nara Medical University, Kashihara, Nara, Japan.
Yoshihiko SaitoDepartment of Cardiology, Nara Medical University, Kashihara, Nara, Japan.
Kazuhiko TsuruyaDepartment of Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Nara Medical University · JPNara Prefecture General Medical Center

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere are fewer reports about whether the presence of hematuria affects the progression of chronic kidney disease in patients with diabetic nephropathy. We analyzed whether microscopic hematuria in diabetic nephropathy is a risk factor for end-stage kidney disease (ESKD). RESEARCH DESIGN AND

methodsThe present study was a retrospective cohort study of patients with biopsy-proven diabetic nephropathy. We recruited 397 patients with diabetic nephropathy, which was confirmed by renal biopsy between June 1981 and December 2014 and followed them until October 2018 or death. Patients with microscopic hematuria before renal biopsy were defined as the hematuria group (n=91), and the remainder as the no-hematuria group (n=306). The main outcome was the occurrence of ESKD, which was defined by the requirement of permanent renal replacement therapies.

resultsThe systolic and diastolic blood pressure, serum creatinine and proteinuria were significantly higher, and the estimated glomerular filtration rate was significantly lower in the hematuria group compared with the no-hematuria group. Pathological evaluations revealed that glomerular, tubulointerstitial and vascular lesions in the hematuria group were significantly more severe. During a median of 10.1 years, 44 and 52 patients developed ESKD in the hematuria group and the no-hematuria group, respectively. Survival analyses showed that the incidence of ESKD was significantly higher in the hematuria group compared with the no-hematuria group (log-rank, p<0.0001). The multivariable Cox proportional hazards models revealed a significant association between hematuria and the incidence of ESKD after adjusting for clinically relevant factors, including proteinuria and renal pathology (adjusted HR 1.64, 95% CI 1.03 to 2.60). The subgroups of men, proteinuria ≥0.5 g/day, and systolic blood pressure ≥132 mm Hg showed a stronger association between hematuria and ESKD than their opposing subgroups.

conclusionsMicroscopic hematuria is a risk factor for ESKD in diabetic nephropathy, independent of proteinuria and renal pathology.

Indexed as

Diabetes MellitusDiabetic NephropathiesHematuriaKidney Failure, ChronicAgedBiopsyFemaleHumansMaleMiddle AgedRetrospective StudiesRisk Factorsbiopsychronicdiabetes mellituskidney failureobservational studytype 2

Identifiers

PMID33148691
PMCPMC7643490
OpenAlexW3096949054

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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.