Evidence map›Paper›PMID 33955699›Full record

ArticleESC heart failure2021

Serum creatinine and cystatin C-based estimates of glomerular filtration rate are misleading in acute heart failure.

Jutta S Swolinsky, Niklas P Nerger, David M Leistner, Frank Edelmann, Fabian Knebel, Enkhtuvshin Tuvshinbat, Caroline Lemke, Robert Roehle, Michael Haase, Maria Rosa Costanzo and 8 more

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

Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.7field-weighted citation impact, top 16% 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

9 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 2 countries.

Jutta S SwolinskyDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Niklas P NergerDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
David M LeistnerDepartment of Internal Medicine and Cardiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
Frank EdelmannClinical Research Unit, Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.
Fabian KnebelDepartment of Cardiology and Angiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Mitte, Berlin, Germany.
Enkhtuvshin TuvshinbatDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Caroline LemkeDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Robert RoehleClinical Research Unit, Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.
Michael HaaseFaculty of Medicine, Otto von-Guericke-University Magdeburg, Magdeburg, Germany.
Maria Rosa CostanzoAdvocate Heart Institute, Naperville, IL, USA.
Geraldine RauchClinical Research Unit, Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.
Veselin MitrovicDepartment of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany.
Edis GasaninDepartment of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany.
Daniel MeierFAST BioMedical, Indianapolis, IN, USA.
Peter A McCulloughBaylor University Medical Center, Baylor Heart and Vascular Hospital, Baylor Heart and Vascular Institute, Dallas, TX, USA.
Kai-Uwe EckardtDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Bruce A MolitorisSchool of Medicine, Indiana University, Indianapolis, IN, USA.
Kai M Schmidt-OttDepartment of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID 0000-0002-7700-7142
Humboldt-Universität zu Berlin · DEKerckhoff Klinik · DEAdvocate Heart Institute · USBaylor University Medical Center · USIndianapolis Zoo · USIndiana University – Purdue University Indianapolis · USMax Delbrück Center · DEOtto-von-Guericke-Universität Magdeburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe aimed to test whether the endogenous filtration markers serum creatinine or cystatin C and equation-based estimates of glomerular filtration rate (GFR) based on these markers appropriately reflect changes of measured GFR in patients with acute heart failure.

methodsIn this prospective cohort study of 50 hospitalized acute heart failure patients undergoing decongestive therapy, we applied an intravenous visible fluorescent injectate (VFI), consisting of a low molecular weight component to measure GFR and a high molecular weight component to correct for measured plasma volume. Thirty-eight patients had two sequential GFR measurements 48 h apart. The co-primary endpoints of the study were safety of VFI and plasma stability of the high molecular weight component. A key secondary endpoint was to compare changes in measured GFR (mGFR) to changes of serum creatinine, cystatin C and estimated GFR.

resultsVFI-based GFR measurements were safe and consistent with plasma stability of the high molecular weight component and glomerular filtration of the low molecular weight component. Filtration marker-based point estimates of GFR, when compared with mGFR, provided only moderate correlation (Pearson's r, range 0.80-0.88, depending on equation used), precision (r

conclusionsIn patients hospitalized for acute heart failure, serum creatinine- and cystatin C-based predictions performed poorly in detecting actual changes of GFR. These data challenge current clinical strategies to evaluate dynamics of kidney function in acute heart failure.

Indexed as

Cystatin CHeart FailureCreatinineGlomerular Filtration RateHumansProspective StudiesCreatinineCystatin CAcute heart failureAcute kidney injuryCKD-EPI formulaMeasured GFRVisible fluorescent injectateWorsening kidney function

Identifiers

PMID33955699
PMCPMC8318462
OpenAlexW3157499518

What OpenQuestion holds

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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.