Evidence map›Paper›PMID 34401728›Full record

ReviewKidney medicine

Hemodialysis-Related Complement and Contact Pathway Activation and Cardiovascular Risk: A Narrative Review.

Sarah C Skinner, Vimal K Derebail, Caroline J Poulton, Donna C Bunch, Prabir Roy-Chaudhury, Nigel S Key

Erratum issuedOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% 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

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Management of antithrombotic therapies in kidney transplantation candidates and recipients: an ERBP clinical practice document by the DESCaRTES Working Group of ERA and the EKITA Committee of ESOT.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Guideline
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  11. Dialysis and cognitive impairment.Nature reviews. Nephrology · 2025
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Sarah C SkinnerDivision of Hematology and UNC Blood Research Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
Vimal K DerebailDivision of Nephrology and UNC Kidney Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
Caroline J PoultonDivision of Nephrology and UNC Kidney Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
Donna C BunchDivision of Nephrology and UNC Kidney Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
Prabir Roy-ChaudhuryDivision of Nephrology and UNC Kidney Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
Nigel S KeyDivision of Hematology and UNC Blood Research Center, Department of Medicine, University of North Carolina, Chapel Hill, NC.
University of North Carolina at Chapel Hill · US

Funding

Research Training in Hematology at UNC Chapel HillT32HL007149 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Nigel S. Key · 1985 to 2026
$8.6M
Mechanism of sickle cell disease-specific venous thromboembolismR01HL157441 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KEY, NIGEL S., PAWLINSKI, RAFAL L · 2021 to 2024
$2.6M
NHLBI NIH HHS R01 HL157441NHLBI NIH HHS T32 HL007149
6 · The paper itself

Abstract

Individuals receiving long-term hemodialysis are at increased risk of developing cardiovascular disease (CVD). Traditional cardiovascular risk factors do not fully explain the high CVD risk in this population. During hemodialysis, blood interacts with the biomaterials of the hemodialysis circuit. This interaction can activate the complement system and the factor XII-driven contact system. FXII activation triggers both the intrinsic pathway of coagulation and the kallikrein-kinin pathway, resulting in thrombin and bradykinin production, respectively. The complement system plays a key role in the innate immune response, but also contributes to the pathogenesis of numerous disease states. Components of the complement pathway, including mannose binding lectin and C3, are associated with CVD risk in people with end-stage kidney disease (ESKD). Both the complement system and the factor XII-driven contact coagulation system mediate proinflammatory and procoagulant responses that could contribute to or accelerate CVD in hemodialysis recipents. This review summarizes what is already known about hemodialysis-mediated activation of the complement system and in particular the coagulation contact system, emphasizing the potential role these systems play in the identification of new biomarkers for CVD risk stratification and the development of potential therapeutic targets or innovative therapies that decrease CVD risk in ESKD patients.

Identifiers

PMID34401728
PMCPMC8350825
OpenAlexW3170490619

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.