Evidence map›Paper›PMID 38488997›Full record

ArticleInternal and emergency medicine2024

High versus low chloride load in adult hyperglycemic emergencies with acute kidney injury: a multicenter retrospective cohort study.

Kyosuke Takahashi, Norimichi Uenishi, Masamitsu Sanui, Shigehiko Uchino, Naoki Yonezawa, Tetsuhiro Takei, Norihiro Nishioka, Hirotada Kobayashi, Shunichi Otaka, Kotaro Yamamoto and 20 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Internal and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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

30 authors at 20 institutions in 4 countries.

Kyosuke Takahashi *Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku, Saitama City, Saitama Prefecture, 330-0834, Japan. ktakahashi@cf.em-net.ne.jp.ORCID 0000-0003-2246-4650
Norimichi Uenishi *Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Masamitsu SanuiDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku, Saitama City, Saitama Prefecture, 330-0834, Japan.
Shigehiko UchinoDepartment of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku, Saitama City, Saitama Prefecture, 330-0834, Japan.
Naoki YonezawaDepartment of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan.
Tetsuhiro TakeiDepartment of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan.
Norihiro NishiokaDepartment of Preventive Services, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan.
Hirotada KobayashiDepartment of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Shunichi OtakaDepartment of Emergency Medicine, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan.
Kotaro YamamotoDepartment of Emergency Medicine, Musashino Red Cross Hospital, Musashino, Tokyo, Japan.
Hideto YasudaDepartment of Emergency Medicine, Musashino Red Cross Hospital, Musashino, Tokyo, Japan.
Shintaro KosakaDepartment of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan.
Hidehiko TokunagaDepartment of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan.
Naoki FujiwaraDepartment of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan.
Takashiro KondoDepartment of Emergency and Critical Care Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan.
Tomoki IshidaNanohana Clinic, Ikuno, Osaka, Japan.
Takayuki KomatsuDepartment of Sports Medicine, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo, Japan.
Koji EndoDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Sakyo, Kyoto, Japan.
Taiki MoriyamaDepartment of Emergency Medicine, Hyogo Emergency Medical Center, Kobe, Hyogo, Japan.
Takayoshi OyasuDepartment of Emergency Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Mineji HayakawaDepartment of Emergency Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.
Atsumi HoshinoDepartment of Critical Care Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
Tasuku MatsuyamaDepartment of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan.
Yuki MiyamotoDepartment of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan.
Akihiro YanagisawaDepartment of Anesthesia, Gyoda General Hospital, Gyoda, Saitama, Japan.
Tadamasa WakabayashiDepartment of Medicine, Suwa Central Hospital, Chino, Nagano, Japan.
Takeshi UedaDepartment of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Nakagyo, Kyoto, Japan.
Tetsuya KomuroDepartment of Medicine, TMG Muneoka Central Hospital, Shiki, Saitama, Japan.
Toshiro SugimotoDepartment of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
Yusuke SasabuchiDepartment of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan.
Jichi Medical University · JPHokkaido University Hospital · JPKyoto Prefectural University of Medicine · JPKyoto University · JPNerima General Hospital · JPYokohama Municipal Minato Red Cross Hospital · JPFujita Health University · JPGunma University Hospital · JPJapanese Red Cross Kumamoto Hospital · JPJuntendo University · JPKobe Medical Center · JPKurashiki Central Hospital · JPMusashino Red Cross Hospital · JPNational Hospital Organization · JPShiga University of Medical Science · JPShonan Kamakura General Hospital · JPSunnybrook Health Science Centre · CASuwa Red Cross Hospital · JPTaizhou Municipal Hospital · CNThe University of Tokyo · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hyperglycemic emergencies frequently lead to acute kidney injury (AKI) and require treatment with large amount of intravenous fluids. However, the effects of chloride loading on this population have not yet been investigated. We conducted a multicenter, retrospective, cohort study in 21 acute-care hospitals in Japan. The study included hospitalized adult patients with diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) who had AKI upon arrival. The patients were classified into high and low chloride groups based on the amount of chloride administered within the first 48 h of their arrival. The primary outcome was recovery from AKI; secondary outcome was major adverse kidney events within 30 days (MAKE30), including mortality and prolonged renal failure. A total of 390 patients with AKI, including 268 (69%) with DKA and 122 (31%) with HHS, were included in the study. Using the criteria of Kidney Disease Improving Global Outcomes, the severity of AKI in the patients was Stage 1 (n = 159, 41%), Stage 2 (n = 121, 31%), and Stage 3 (n = 110, 28%). The analysis showed no significant difference between the two groups in recovery from AKI (adjusted hazard ratio, 0.96; 95% CI 0.72-1.28; P = 0.78) and in MAKE30 (adjusted odds ratio, 0.91; 95% CI 0.45-1.76; P = 0.80). Chloride loading with fluid administration had no significant impact on recovery from AKI in patients with hyperglycemic emergencies.Trial Registration This study was registered in the UMIN clinical trial registration system (UMIN000025393, registered December 23, 2016).

Indexed as

Acute Kidney InjuryDiabetic KetoacidosisAdultAgedChloridesCohort StudiesEmergenciesFemaleFluid TherapyHumansHyperglycemiaHyperglycemic Hyperosmolar Nonketotic ComaJapanMaleMiddle AgedRetrospective StudiesChloridesAcute kidney injuryDiabetesDiabetic ketoacidosisHyperglycemic crisisHyperosmolar hyperglycemic stateHyperosmolar hyperglycemic syndrome

Identifiers

PMID38488997
OpenAlexW4392863835

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.