Evidence map›Paper›PMID 26092828›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2015

Cardiac autonomic neuropathy and early progressive renal decline in patients with nonmacroalbuminuric type 1 diabetes.

Steven Orlov, David Z I Cherney, Rodica Pop-Busui, Leif E Lovblom, Linda H Ficociello, Adam M Smiles, James H Warram, Andrzej S Krolewski, Bruce A Perkins

Abstract read
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In one paragraph

Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
2.8field-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

36 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.

  1. Pooled it
  2. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
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  17. Arrhythmias in Chronic Kidney Disease.European cardiology · 2022
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Steven OrlovDivision of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;
David Z I CherneyDivision of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada;
Rodica Pop-BusuiDivision of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan Health System, University of Michigan, Ann Arbor, Michigan; and.
Leif E LovblomDivision of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada;
Linda H FicocielloSection on Genetics and Epidemiology, Research Division, Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
Adam M SmilesSection on Genetics and Epidemiology, Research Division, Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
James H WarramSection on Genetics and Epidemiology, Research Division, Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
Andrzej S KrolewskiSection on Genetics and Epidemiology, Research Division, Department of Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
Bruce A PerkinsDivision of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; bperkins@mtsinai.on.ca.
Harvard University · USJoslin Diabetes Center · USMount Sinai Hospital · CAUniversity of Toronto · CAMichigan Medicine · US

Funding

Regional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DAVID P OLSON · 2013 to 2026
$24.3M
Tumor necrosis factor superfamily of ligands and receptors in progressive renal decline in diabetesR01DK041526 · NIDDK · JOSLIN DIABETES CENTER · PI KROLEWSKI, ANDRZEJ S · 1990 to 2018
$7.8M
NIDDK NIH HHS P30 DK020572NIDDK NIH HHS R01 DK041526NIDDK NIH HHS R01-DK41526
6 · The paper itself

Abstract

BACKGROUND AND

objectivesCardiac autonomic neuropathy predicts future adverse renal outcomes in the general population. This study sought to determine its relationship with early progressive renal decline in type 1 diabetes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A subset of participants with normoalbuminuria (n=204) or microalbuminuria (n=166) from the First Joslin Kidney Study underwent assessment for cardiac autonomic neuropathy using heart rate variability during baseline visits performed from January 1991 to April 1992. Cardiac autonomic neuropathy was defined as an R-R variation (mean circular resultant) <20. Participants also had baseline and follow-up measurement of eGFR. Early progressive renal decline was evaluated according to two definitions: early GFR loss (slope of eGFR estimated by cystatin C <-3.3%/year) and incident advanced CKD (stage ≥3, defined by eGFR [calculated by Modification of Diet in Renal Disease method] <60 ml/min per 1.73 m(2)). Association with baseline cardiac autonomic neuropathy was assessed by adjusted logistic regression and Cox proportional hazards.

resultsAmong the 370 participants, 47 (13%) had baseline cardiac autonomic neuropathy, 51 (14%) had early GFR loss, and 68 (18%) had incident advanced CKD over a median 14-year follow-up. Early GFR loss occurred in 15 (32%) of the 47 patients with baseline autonomic neuropathy and in 32 (10%) of the 323 without baseline autonomic neuropathy (P<0.001). Baseline autonomic neuropathy was strongly associated with odds of early GFR loss (adjusted odds ratio, 4.09; 95% confidence interval, 1.65 to 10.12; P=0.002). Incident advanced CKD was observed in 22 (47%) of those with baseline autonomic neuropathy and 46 (14%) of those without baseline autonomic neuropathy (P<0.001). Autonomic neuropathy was independently associated with incident advanced CKD (adjusted hazard ratio, 2.76; 95% confidence interval, 1.44 to 5.30; P=0.002).

conclusionsCardiac autonomic neuropathy was a strong independent predictor of the long-term risk of early progressive renal decline in type 1 diabetes. Future research should explore the mechanisms by which autonomic neuropathy may be associated with renal function loss.

Indexed as

AdolescentAdultAutonomic Nervous SystemBiomarkersBostonCystatin CDiabetes Mellitus, Type 1Diabetic NephropathiesDiabetic NeuropathiesDisease ProgressionFemaleFollow-Up StudiesGlomerular Filtration RateHeartHeart RateHumansBiomarkersCST3 protein, humanCystatin CalbuminuriaCKDdiabetesrenal function

Identifiers

PMID26092828
PMCPMC4491301
OpenAlexW2401113515

What Socratic 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 Socratic graph.