Evidence map›Paper›PMID 34233923›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2021

Effect of Hemodiafiltration on the Progression of Neuropathy with Kidney Failure: A Randomized Controlled Trial.

Amy Kang, Ria Arnold, Martin Gallagher, Paul Snelling, Julianne Green, Mangalee Fernando, Matthew C Kiernan, Samantha Hand, Kim Grimley, Jenny Burman and 10 more

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 13% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Haemodiafiltration versus high-flux haemodialysis-a Consensus Statement from the EuDial Working Group of the ERA.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Article
  5. Review
  6. Article
  7. Review
  8. Review
  9. Advances in hemodialysis therapy.Faculty reviews · 2023
    Review
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 2 countries.

Amy KangRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0300-1282
Ria ArnoldDepartment of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Martin GallagherRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Paul SnellingDepartment of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Julianne GreenDepartment of Renal Medicine, Sydney Adventist Hospital, Sydney, New South Wales, Australia.
Mangalee FernandoDepartment of Renal Medicine, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Matthew C KiernanDepartment of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Samantha HandDepartment of Renal Medicine, Concord Hospital, Sydney, New South Wales, Australia.
Kim GrimleyDepartment of Renal Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Jenny BurmanDepartment of Renal Medicine, Concord Hospital, Sydney, New South Wales, Australia.
Anne HeathDepartment of Renal Medicine, Sydney Adventist Hospital, Sydney, New South Wales, Australia.
Kris RogersStatistics Division, The George Institute The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Amritendu BhattacharyaStatistics Division, The George Institute The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-6237-7290
Brendan SmythRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-1838-3348
Thomas BradburyRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Carmel HawleyAustralasian Kidney Trials Network, University of Queensland, Brisbane, Queensland, Australia.
Vlado PerkovicRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Arun V KrishnanDepartment of Medicine, University of New South Wales Sydney, Sydney, New South Wales, Australia.
Meg J JardineRenal and Metabolic Division, The George Institute, University of New South Wales Sydney, Sydney, New South Wales, Australia.
FINESSE Steering Committee
UNSW Sydney · AUConcord Repatriation General Hospital · AUThe University of Sydney · AURoyal Prince Alfred Hospital · AUSydney Adventist Hospital · AUThe University of Queensland · AUUniversity of Technology Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesNeuropathy is a common complication of kidney disease that lacks proven disease-modifying treatments. Hemodiafiltration improves clearance of uremic toxins and is associated with better nerve function than hemodialysis. We aimed to determine whether hemodiafiltration reduces the progression of neuropathy in people receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution (FINESSE) study was an open-label, blinded end point assessment, controlled trial that randomized maintenance hemodialysis recipients to hemodiafiltration or high-flux hemodialysis for 48 months or until death or cessation of dialysis at four study centers. The primary outcome was the mean change in the yearly modified total neuropathy score from baseline, with time points weighted equally.

resultsA total of 124 participants were randomized and followed for a mean of 41 months. At baseline, neuropathy was present in 91 (73%) participants (modified total neuropathy score greater than or equal to two), and 38 (31%) had moderate to severe neuropathy (modified total neuropathy score 9-28). Convection volume in the hemodiafiltration arm was a median of 24.7 (interquartile range, 22.4-26.5) L. The mean modified total neuropathy score (SEM) worsened by 1.7 (0.4)/28 and 1.2 (0.4)/28 in the hemodiafiltration and hemodialysis groups, respectively, with a mean difference of 0.5 (95% confidence interval, -0.7 to 1.7;

conclusionsNeuropathy is still a common complication of kidney disease without disease-altering therapy. Hemodiafiltration did not affect neuropathy progression compared with hemodialysis. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: Filtration in the Neuropathy of End-Stage Kidney Disease Symptom Evolution (FINESSE), ACTRN12609000615280.

Indexed as

HemodiafiltrationAgedAged, 80 and overDisease ProgressionFemaleHumansKidney Failure, ChronicMaleMiddle AgedPeripheral Nervous System DiseasesProspective StudiesRenal Dialysischronic dialysischronic hemodialysisclinical trialdialysisend-stage renal diseasehemodiafiltrationhemodialysisneuropathyrandomized controlled trialsuremic neuropathy

Identifiers

PMID34233923
PMCPMC8729572
OpenAlexW3182422198

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.