Evidence map›Paper›PMID 31542753›Full record

SynthesisBMJ open2019

Effects of antihypertensives, lipid-modifying drugs, glycaemic control drugs and sodium bicarbonate on the progression of stages 3 and 4 chronic kidney disease in adults: a systematic review and meta-analysis.

Kathryn S Taylor, Julie Mclellan, Jan Y Verbakel, Jeffrey K Aronson, Daniel S Lasserson, Nicola Pidduck, Nia Roberts, Susannah Fleming, Christopher A O'Callaghan, Clare R Bankhead and 3 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 15% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Association of lipid profiles with severity and outcome of acute ischemic stroke in patients with and without chronic kidney disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
    Article
  6. Review
  7. Review
  8. Uncoded chronic kidney disease in primary care: a cross-sectional study of inequalities and cardiovascular disease risk management.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Article
  9. 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

13 authors at 3 institutions in 3 countries.

Kathryn S TaylorNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Julie MclellanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK julie.mclellan@phc.ox.ac.uk.ORCID 0000-0002-2868-8631
Jan Y VerbakelNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jeffrey K AronsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Daniel S LassersonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-8274-5580
Nicola PidduckNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nia RobertsBodleian Health Care Libraries, University of Oxford, Oxford, UK.
Susannah FlemingNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7205-2051
Christopher A O'CallaghanJohn Radcliffe Hospital, Oxford Radcliffe Hospitals Trust, Oxford, UK.
Clare R BankheadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Amitava BanerjeeFarr Institute of Health Informatics Research, University College London, London, UK.ORCID 0000-0001-8741-3411
Fd Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
University of Oxford · GBFarr Institute · GBJohn Radcliffe Hospital · GB

Funding

Department of Health 12/01/52Department of Health IS-SPC-0514-10043Department of Health RP-PG-1210-12003Medical Research Council MC_PC_11004
6 · The paper itself

Abstract

objectiveTo evaluate the effects of drug interventions that may modify the progression of chronic kidney disease (CKD) in adults with CKD stages 3 and 4.

designSystematic review and meta-analysis.

methodsSearching MEDLINE, EMBASE, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, International Clinical Trials Registry Platform, Health Technology Assessment, Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index and Clinical Trials Register, from March 1999 to July 2018, we identified randomised controlled trials (RCTs) of drugs for hypertension, lipid modification, glycaemic control and sodium bicarbonate, compared with placebo, no drug or a drug from another class, in ≥40 adults with CKD stages 3 and/or 4, with at least 2 years of follow-up and reporting renal function (primary outcome), proteinuria, adverse events, maintenance dialysis, transplantation, cardiovascular events, cardiovascular mortality or all-cause mortality. Two reviewers independently screened citations and extracted data. For continuous outcomes, we used the ratio of means (ROM) at the end of the trial in random-effects meta-analyses. We assessed methodological quality with the Cochrane Risk of Bias Tool and confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

resultsWe included 35 RCTs and over 51 000 patients. Data were limited, and heterogeneity varied. Final renal function (estimated glomerular filtration rate) was 6% higher in those taking glycaemic control drugs (ROM 1.06, 95% CI 1.02 to 1.10, I

conclusionsGlycaemic control and lipid-modifying drugs may slow the progression of CKD, but we found no pooled evidence of benefit nor harm from antihypertensive drugs. However, given the data limitations, further research is needed to confirm these findings. PROSPERO REGISTRATION NUMBER: CRD42015017501.

Indexed as

AdultAntihypertensive AgentsDisease ProgressionHumansHypoglycemic AgentsHypolipidemic AgentsRandomized Controlled Trials as TopicRenal Insufficiency, ChronicSeverity of Illness IndexSodium BicarbonateTreatment OutcomeAntihypertensive AgentsHypoglycemic AgentsHypolipidemic AgentsSodium BicarbonateCardiovascular eventsChronic renal failureDrug treatmentMeta-analysisRenal function

Identifiers

PMID31542753
PMCPMC6756484
OpenAlexW2972790393

What Socratic holds

Textmetadata
LicenceCC BY
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.