Evidence map›Paper›PMID 32188697›Full record

Trial reportJournal of the American Society of Nephrology : JASN2020

Effect of Low-Sodium versus Conventional Sodium Dialysate on Left Ventricular Mass in Home and Self-Care Satellite Facility Hemodialysis Patients: A Randomized Clinical Trial.

Mark R Marshall, Alain C Vandal, Janak R de Zoysa, Ruvin S Gabriel, Imad A Haloob, Christopher J Hood, John H Irvine, Philip J Matheson, David O R McGregor, Kannaiyan S Rabindranath and 6 more

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 5 pooled it
4.0field-weighted citation impact, top 5% 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

21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Low dialysate sodium levels for chronic haemodialysis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Guideline
  6. Dialysate Sodium Lowering in Maintenance Hemodialysis: A Randomized Clinical Trial.Clinical journal of the American Society of Nephrology : CJASN · 2024
    Trial
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Article
  13. Article
  14. Sodium handling in pediatric patients on maintenance dialysis.Pediatric nephrology (Berlin, Germany) · 2023
    Review
  15. Review
  16. Review
  17. Article
  18. Article
  19. Review
  20. 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

16 authors at 9 institutions in 2 countries.

Mark R MarshallDepartment of Renal Medicine, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand; markrogermarshall@icloud.com.ORCID 0000-0003-0499-4527
Alain C VandalDepartment of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand.
Janak R de ZoysaDepartment of Renal Medicine, North Shore Hospital, Waitemata District Health Board, Auckland, New Zealand.ORCID 0000-0001-7528-9230
Ruvin S GabrielDepartment of Cardiology, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Imad A HaloobDepartment of Renal Medicine, Bathurst Base Hospital, New South Wales, Bathurst, Australia.
Christopher J HoodDepartment of Renal Medicine, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
John H IrvineDepartment of Nephrology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
Philip J MathesonDepartment of Nephrology, Wellington Hospital, Capital & Coast District Health Board, Wellington, New Zealand.
David O R McGregorDepartment of Nephrology, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.
Kannaiyan S RabindranathDepartment of Nephrology, Waikato Hospital, Waikato District Health Board, Hamilton, New Zealand.
John B W SchollumNephrology Service, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand.
David J SempleDepartment of Renal Medicine, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
Zhengxiu XieMiddlemore Clinical Trials, Auckland, New Zealand; and.
Tian Min MaDepartment of Renal Medicine, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand; markrogermarshall@icloud.com.
Rose SiskDivision of Informatics, Imaging & Data Sciences, School of Health Sciences, University of Manchester, Manchester, United Kingdom.
Joanna L DunlopDepartment of Renal Medicine, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Middlemore Hospital · NZUniversity of Auckland · NZChristchurch Hospital · NZAuckland City Hospital · NZDunedin Public Hospital · NZManchester Academic Health Science Centre · GBMiddlemore Clinical Trials · NZWaikato Hospital · NZWellington Hospital · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluid overload in patients undergoing hemodialysis contributes to cardiovascular morbidity and mortality. There is a global trend to lower dialysate sodium with the goal of reducing fluid overload.

methodsTo investigate whether lower dialysate sodium during hemodialysis reduces left ventricular mass, we conducted a randomized trial in which patients received either low-sodium dialysate (135 mM) or conventional dialysate (140 mM) for 12 months. We included participants who were aged >18 years old, had a predialysis serum sodium ≥135 mM, and were receiving hemodialysis at home or a self-care satellite facility. Exclusion criteria included hemodialysis frequency >3.5 times per week and use of sodium profiling or hemodiafiltration. The main outcome was left ventricular mass index by cardiac magnetic resonance imaging.

resultsThe 99 participants had a median age of 51 years old; 67 were men, 31 had diabetes mellitus, and 59 had left ventricular hypertrophy. Over 12 months of follow-up, relative to control, a dialysate sodium concentration of 135 mmol/L did not change the left ventricular mass index, despite significant reductions at 6 and 12 months in interdialytic weight gain, in extracellular fluid volume, and in plasma B-type natriuretic peptide concentration (ratio of intervention to control). The intervention increased intradialytic hypotension (odds ratio [OR], 7.5; 95% confidence interval [95% CI], 1.1 to 49.8 at 6 months and OR, 3.6; 95% CI, 0.5 to 28.8 at 12 months). Five participants in the intervention arm could not complete the trial because of hypotension. We found no effect on health-related quality of life measures, perceived thirst or xerostomia, or dietary sodium intake.

conclusionsDialysate sodium of 135 mmol/L did not reduce left ventricular mass relative to control, despite improving fluid status. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: The Australian New Zealand Clinical Trials Registry, ACTRN12611000975998.

Indexed as

AgedDiabetic NephropathiesFemaleHeart VentriclesHemodialysis, HomeHemodialysis SolutionsHumansHypertrophy, Left VentricularHypotensionMaleMiddle AgedOrgan SizeOutpatient Clinics, HospitalRenal DialysisSelf CareSodiumHemodialysis SolutionsSodiumclinical trialhemodialysishypertensionhypotensionleft ventricular hypertrophy

Identifiers

PMID32188697
PMCPMC7217404
OpenAlexW3010661709

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.