ArticleKidney medicine2026
Lower- Versus Conventional-Sodium Dialysate and Left Ventricular Mass in Patients Receiving Hemodialysis: Causal Analyses of a Randomized Clinical Trial.
Article in Kidney medicine, 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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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.
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Authors and funding
15 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Rationale & Objective: In a recent trial, allocation to lower dialysate [Na Study Design: We defined a causal pathway between allocation and LVMI, quantifying effects between physiological variables within the model. Setting & Participants: Home and self-care satellite hemodialysis patients. Exposure: Allocation to lower dialysate [Na Outcome: LVMI. Analytic Approach: We used structural equations for path analysis to estimate simultaneous effects of the main exposure on intermediary outcomes and intermediary outcomes on the main outcome. Results: The following latent constructs were identified as intermediary outcomes: "Fluid Volume" (indicated by N-terminal proBNP and BNP levels, overhydration index from bioimpedance analysis, and left ventricular end-diastolic volume from cardiac magnetic resonance imaging); "Dialytic BP" (indicated by pre-/postdialysis blood pressure [BP] measurements), "Interdialytic BP" (indicated by home/ambulatory BP measurements), antihypertensive dose, and IDWG. In the structural model, fluid volume had a large effect on LVMI (standardized path coefficient, 0.51; 95% CI, 0.35-0.67), and smaller ones on Dialytic BP and Interdialytic BP (respectively: 0.31; 95% CI, 0.15-0.47 and 0.22; 95% CI, 0.02-0.41). Dialytic BP and Interdialytic BP had small-to-medium-sized effects on LVMI (respectively: 0.23; 95% CI, 0.04-0.42 and 0.22; 95% CI, 0.07-0.37). Neither IDWG nor antihypertensive dose affected LVMI. Allocation to lower dialysate [Na Limitations: Allocation rather than the intervention itself; residual confounding from unrecorded intermediary outcomes. Conclusions: Allocation to lower dialysate [Na
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