Evidence map›Paper›PMID 33752200›Full record

ArticleNephron2021

Potassium Trajectories prior to Dialysis and Mortality following Dialysis Initiation in Patients with Advanced CKD.

Ankur A Dashputre, Keiichi Sumida, Praveen K Potukuchi, Suryatapa Kar, Yoshitsugu Obi, Fridtjof Thomas, Miklos Z Molnar, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy

Abstract read
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In one paragraph

Article in Nephron, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
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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

10 authors.

Ankur A DashputreInstitute for Health Outcomes and Policy, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Keiichi SumidaDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Praveen K PotukuchiInstitute for Health Outcomes and Policy, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Suryatapa KarDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Yoshitsugu ObiDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Fridtjof ThomasDivision of Biostatistics, Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Miklos Z MolnarDivision of Nephrology and Hypertension, Department of Medicine, University of Utah, Salt Lake City, Utah, USA.
Elani StrejaDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California-Irvine, Orange, California, USA.
Kamyar Kalantar-ZadehDivision of Nephrology and Hypertension, Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California-Irvine, Orange, California, USA.
Csaba P KovesdyDivision of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA, ckovesdy@uthsc.edu.

Funding

Transition of Care in CKD (TC-CKD)U01DK102163 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI JACOBSEN, STEVEN J, KALANTAR-ZADEH, KAMYAR · 2014 to 2018
$2.8M
NIDDK NIH HHS U01 DK102163
6 · The paper itself

Abstract

introductionPatients with advanced non-dialysis-dependent CKD (NDD-CKD) have a reduced ability for maintaining plasma potassium (K) in normal range. Deviation from normal plasma K ranges is associated with increased mortality; however, the average trajectory of plasma K over time in patients with advanced NDD-CKD and the outcomes associated with plasma K trajectory are unknown.

methodsWe identified 34,167 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 and March 2015 with at least 1 K measurement each year over a 3-year period prior to dialysis transition (3-year prelude). The K trajectory defined as the change in K (slope) per year over the entire 3-year prelude was estimated using linear mixed-effects models. The association between unadjusted (crude) K slope (categorized as stable [-0.09 to 0.09 mEq/L/year], decreasing [≤-0.10 mEq/L/year], and increasing [≥0.10 mEq/L/year]) and time to all-cause and cardiovascular mortality during the 6 months following dialysis initiation was assessed using multivariable-adjusted survival models.

resultsThe crude and multivariable-adjusted K slopes (mean, 95% CI) over the 3-year prelude were 0.008 (0.0059, 0.0110) and -0.15 mEq/L/year (-0.19, -0.11), respectively. Decreasing K slope was associated with higher multivariable-adjusted risk of all-cause mortality (adjusted hazard ratio [95% CI] vs. stable K slope: 1.08 [1.00-1.17]). No association was observed between K slope and cardiovascular mortality. DISCUSSION/

conclusionThe average intraindividual plasma K trajectory is remarkably stable in patients with advanced NDD-CKD. A decreasing K slope is associated with higher all-cause mortality risk.

Indexed as

Renal DialysisAgedFemaleHumansKidney Failure, ChronicMaleMiddle AgedPotassiumUnited StatesVeteransPotassiumChronic kidney diseaseDialysisMortalityPotassiumSlope

Identifiers

PMID33752200
PMCPMC8102350

What Socratic holds

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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.