Evidence map›Paper›PMID 33895727›Full record

ArticleAmerican journal of nephrology2021

Association of Pre-ESRD Serum Bicarbonate with Post-ESRD Mortality in Patients with Incident ESRD.

Ekamol Tantisattamo, Victoria Murray, Yoshitsugu Obi, Christina Park, Christina J Catabay, Yuji Lee, Cachet Wenziger, Jui-Ting Hsiung, Melissa Soohoo, Carola-Ellen Kleine and 5 more

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

Article in American journal of nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 35% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. 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

15 authors at 3 institutions in 1 country.

Ekamol TantisattamoHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Victoria MurrayFielding School of Public Health at UCLA, Los Angeles, California, USA.
Yoshitsugu ObiHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Christina ParkHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Christina J CatabayHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Yuji LeeHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Cachet WenzigerHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Jui-Ting HsiungHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Melissa SoohooHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Carola-Ellen KleineHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Connie M RheeHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Jeffrey KrautFielding School of Public Health at UCLA, Los Angeles, California, USA.
Csaba P KovesdyDivision of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Kamyar Kalantar-ZadehHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
Elani StrejaHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology, Hypertension and Kidney Transplantation, Department of Medicine, School of Medicine, University of California Irvine, Orange, California, USA.
University of California, Irvine · USFielding Graduate University · USUniversity of Tennessee Health Science Center · US

Funding

Transition of Care in CKD (TC-CKD)U01DK102163 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI JACOBSEN, STEVEN J, KALANTAR-ZADEH, KAMYAR · 2014 to 2018
$2.8M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Examining Racial and Cardiovascular Paradoxes in Chronic Kidney DiseaseR01DK078106 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR · 2007 to 2011
$1.1M
Comparative Effectiveness of Dialysis ModalitiesR01DK095668 · NIDDK · UNIVERSITY OF WASHINGTON · PI KALANTAR-ZADEH, KAMYAR, MEHROTRA, RAJNISH · 2012 to 2014
$1.0M
Hypothyroidism, Cardiovascular Health, and Survival in Kidney DiseaseK23DK102903 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2014 to 2018
$955k
Racial and Cardiovascular Risk Factor Anomalies in CKDR01DK096920 · NIDDK · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI KALANTAR-ZADEH, KAMYAR, KOVESDY, CSABA PAL · 2013 to 2015
$909k
Improving Analysis of Endogenous Multimodal Treatments for Use in Geriatrics Health Outcomes StudiesI01HX002237 · VA · VA BOSTON HEALTH CARE SYSTEM · PI GARRIDO, MELISSA M · 2018 to 2021
–
Lipid Profiles and Management in Veterans with Chronic Kidney DiseaseIK2CX001266 · VA · VETERANS HEALTH ADMINISTRATION · PI STREJA, ELANI · 2016 to 2021
–
CSRD VA IK2 CX001266HSRD VA SDR 02-237NIDDK NIH HHS K23 DK102903NIDDK NIH HHS K24 DK091419NIDDK NIH HHS R01 DK078106NIDDK NIH HHS R01 DK095668NIDDK NIH HHS R01 DK096920NIDDK NIH HHS U01 DK102163
6 · The paper itself

Abstract

backgroundSerum bicarbonate or total carbon dioxide (CO2) concentrations decline as chronic kidney disease (CKD) progresses and rise after dialysis initiation. While metabolic acidosis accelerates the progression of CKD and is associated with higher mortality among patients with end stage renal disease (ESRD), there are scarce data on the association of CO2 concentrations before ESRD transition with post-ESRD mortality.

methodsA historical cohort from the Transition of Care in CKD (TC-CKD) study includes 85,505 veterans who transitioned to ESRD from October 1, 2007, through March 31, 2014. After 1,958 patients without follow-up data, 3 patients with missing date of birth, and 50,889 patients without CO2 6 months prior to ESRD transition were excluded, the study population includes 32,655 patients. Associations between CO2 concentrations averaged over the last 6 months and its rate of decline during the 12 months prior to ESRD transition and post-ESRD all-cause, cardiovascular (CV), and non-CV mortality were examined by using hierarchical adjustment with Cox regression models.

resultsThe cohort was on average 68 ± 11 years old and included 29% Black veterans. Baseline concentrations of CO2 were 23 ± 4 mEq/L, and median (interquartile range) change in CO2 were -1.8 [-3.4, -0.2] mEq/L/year. High (≥28 mEq/L) and low (<18 mEq/L) CO2 concentrations showed higher adjusted mortality risk while there was no clear trend in the middle range. Consistent associations were observed irrespective of sodium bicarbonate use. There was also a U-shaped association between the change in CO2 and all-cause, CV, and non-CV mortality with the lowest risk approximately at -2.0 and 0.0 mEq/L/year among sodium bicarbonate nonusers and users, respectively, and the highest mortality was among patients with decline in CO2 >4 mEq/L/year.

conclusionBoth high and low pre-ESRD CO2 levels (≥28 and <18 mEq/L) during 6 months prior to dialysis transition and rate of CO2 decline >4 mEq/L/year during 1 year before dialysis initiation were associated with greater post-ESRD all-cause, CV, and non-CV mortality. Further studies are needed to determine the optimal management of CO2 in patients with advanced CKD stages transitioning to ESRD.

Indexed as

AgedBicarbonatesDisease ProgressionFemaleHumansKidney Failure, ChronicMaleMiddle AgedRenal Insufficiency, ChronicBicarbonatesBicarbonateChronic kidney diseaseEnd-stage renal diseaseEnd-stage renal disease transitionMetabolic acidosisMetabolic alkalosisMortality

Identifiers

PMID33895727
PMCPMC8184571
OpenAlexW3158104516

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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.