Evidence map›Paper›PMID 42446819›Full record

ArticleClinical and experimental nephrology2026

Zinc deficiency and antihypertensive treatment intensity in patients initiating dialysis: a cross-sectional analysis from the Jikei hemodialysis and peritoneal dialysis study (JHPS).

Ayaka Hayashi, Izumi Yamamoto, Yutaro Ohki, Mayuko Kawabe, Takafumi Kuroda, Makoto Sagasaki, Akio Nakashima, Go Kanzaki, Mahiro Kurashige, Kei Matsumoto and 5 more

Abstract read
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In one paragraph

Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Ayaka HayashiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Izumi YamamotoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan. izumi26@jikei.ac.jp.ORCID http://orcid.org/0000-0002-9856-0852
Yutaro OhkiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Mayuko KawabeDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Takafumi KurodaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Makoto SagasakiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Akio NakashimaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Go KanzakiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Mahiro KurashigeDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Kei MatsumotoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Nanae MatsuoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Hiroyuki UedaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Ichiro OhkidoDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Nobuo TsuboiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Takashi YokooDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSerum zinc levels decline with chronic kidney disease (CKD) progression, and zinc deficiency has been linked to impaired urinary sodium excretion and hypertension. However, its clinical impact on hypertension management in end-stage kidney disease remains unclear. This study investigated the association between serum zinc deficiency and antihypertensive treatment intensity in patients with stage 5 CKD initiating dialysis.

methodsIn this single-center cross-sectional study, 175 adults initiating hemodialysis or peritoneal dialysis between November 2021 and December 2024 were included. Serum zinc levels were measured at dialysis initiation, and zinc deficiency was defined as < 60 μg/dL. Logistic and ordered logistic regression analyses adjusted for demographic and hypertension-related factors were conducted to evaluate factors associated with zinc deficiency and its relationship with the number of prescribed antihypertensive agents.

resultsZinc deficiency was present in 59.4% of patients. Patients with zinc deficiency required more antihypertensive agents than those without deficiency. Zinc deficiency was significantly associated with antihypertensive agent number in univariate analyses and remained an independent factor in multivariate logistic regression (adjusted OR 1.6, 95% CI 1.0-2.4). Ordered logistic regression further demonstrated an independent association between zinc deficiency and greater antihypertensive treatment intensity after adjustment for age, sex, and hypertension-related risk factors (adjusted OR 2.4, 95% CI 1.1-5.3).

conclusionZinc deficiency was independently associated with more intensive antihypertensive therapy. These findings suggest that zinc deficiency may contribute to antihypertensive treatment intensity in advanced CKD. Assessment of zinc status may offer an underrecognized opportunity to improve blood pressure control in this population.

Indexed as

Antihypertensive AgentsHypertensionKidney Failure, ChronicRenal DialysisZincAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedPeritoneal DialysisRisk FactorsAntihypertensive AgentsZincAntihypertensive therapyAntihypertensive treatment intensityCKDDialysis initiationZinc deficiency

Identifiers

PMID42446819

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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.