Evidence map›Paper›PMID 34473302›Full record

Trial reportNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2022

Kidney tubule health, mineral metabolism and adverse events in persons with CKD in SPRINT.

Simon B Ascher, Rebecca Scherzer, Michelle M Estrella, Jarett D Berry, James A de Lemos, Vasantha K Jotwani, Pranav S Garimella, Rakesh Malhotra, Alexander L Bullen, Ronit Katz and 7 more

Open access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 23% 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

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Associations of Urine Biomarkers During Ambulatory Acute Kidney Injury With Subsequent Recovery in Kidney Function: Findings From the SPRINT Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025
    Trial
  2. 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

17 authors at 8 institutions in 1 country.

Simon B AscherDepartment of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco, CA, USA.
Rebecca ScherzerDepartment of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco, CA, USA.
Michelle M EstrellaDepartment of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco, CA, USA.
Jarett D BerryDivison of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
James A de LemosDivison of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Vasantha K JotwaniDepartment of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco, CA, USA.
Pranav S GarimellaDivision of Nephrology-Hypertension, University of California San Diego, San Diego, CA, USA.
Rakesh MalhotraDivision of Nephrology-Hypertension, University of California San Diego, San Diego, CA, USA.
Alexander L BullenDivision of Nephrology-Hypertension, University of California San Diego, San Diego, CA, USA.
Ronit KatzDepartment of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
Walter T AmbrosiusDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Alfred K CheungDivision of Nephrology and Hypertension, University of Utah Health, Salt Lake City, UT, USA.
Michel ChoncholDivision of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO, USA.
Anthony A KilleenDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.ORCID 0000-0003-1629-9468
Joachim H IxDivision of Nephrology-Hypertension, University of California San Diego, San Diego, CA, USA.
Michael G ShlipakDepartment of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco, CA, USA.
SPRINT Research Group
University of California, San Francisco · USUniversity of California San Diego · USThe University of Texas Southwestern Medical Center · USUniversity of Colorado Denver · USUniversity of Minnesota · USUniversity of Utah · USUniversity of Washington · USWake Forest University · US

Funding

INSTITUTIONAL CLINICAL AND TRANSLATIONAL SCIENCE AWARDUL1RR024134 · NCRR · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2006 to 2011
$70.4M
University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Tufts Clinical and Translational Research InstituteUL1TR001064 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$26.4M
University of Iowa Clinical and Translational Science Program (TL1)UL1RR025755 · NCRR · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2008 to 2011
$26.3M
CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR025771 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI CENTER, DAVID M. · 2008 to 2011
$17.6M
NCATS NIH HHS UL1 TR000002NCATS NIH HHS UL1 TR000003NCATS NIH HHS UL1 TR000005NCATS NIH HHS UL1 TR000050NCATS NIH HHS UL1 TR000064NCATS NIH HHS UL1 TR000073NCATS NIH HHS UL1 TR000075NCATS NIH HHS UL1 TR000093NCATS NIH HHS UL1 TR000105NCATS NIH HHS UL1 TR000433NCATS NIH HHS UL1 TR000439NCATS NIH HHS UL1 TR000445NCATS NIH HHS UL1 TR001064NCATS NIH HHS UL1 TR001420NCATS NIH HHS UL1 TR002548NCATS NIH HHS UL1 TR003142NCRR NIH HHS UL1 RR024134NCRR NIH HHS UL1 RR025752NCRR NIH HHS UL1 RR025755NCRR NIH HHS UL1 RR025771NHLBI NIH HHS HHSN268200900040CNHLBI NIH HHS HHSN268200900046CNHLBI NIH HHS HHSN268200900047CNHLBI NIH HHS HHSN268200900048CNHLBI NIH HHS HHSN268200900049CNHLBI NIH HHS R01 HL144112NIDDK NIH HHS K24 DK110427NIDDK NIH HHS P30 DK127984NIDDK NIH HHS R01 DK098234NIGMS NIH HHS P30 GM103337
6 · The paper itself

Abstract

backgroundMeasures of kidney tubule health are risk markers for acute kidney injury (AKI) in persons with chronic kidney disease (CKD) during hypertension treatment, but their associations with other adverse events (AEs) are unknown.

methodsAmong 2377 Systolic Blood Pressure Intervention Trial (SPRINT) participants with CKD, we measured at baseline eight urine biomarkers of kidney tubule health and two serum biomarkers of mineral metabolism pathways that act on the kidney tubules. Cox proportional hazards models were used to evaluate biomarker associations with risk of a composite of pre-specified serious AEs (hypotension, syncope, electrolyte abnormalities, AKI, bradycardia and injurious falls) and outpatient AEs (hyperkalemia and hypokalemia).

resultsAt baseline, the mean age was 73 ± 9 years and mean estimated glomerular filtration rate (eGFR) was 46 ± 11 mL/min/1.73 m2. During a median follow-up of 3.8 years, 716 (30%) participants experienced the composite AE. Higher urine interleukin-18, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin (NGAL) and monocyte chemoattractant protein-1 (MCP-1), lower urine uromodulin (UMOD) and higher serum fibroblast growth factor-23 were individually associated with higher risk of the composite AE outcome in multivariable-adjusted models including eGFR and albuminuria. When modeling biomarkers in combination, higher NGAL [hazard ratio (HR) = 1.08 per 2-fold higher biomarker level, 95% confidence interval (CI) 1.03-1.13], higher MCP-1 (HR = 1.11, 95% CI 1.03-1.19) and lower UMOD (HR = 0.91, 95% CI 0.85-0.97) were each associated with higher composite AE risk. Biomarker associations did not vary by intervention arm (P > 0.10 for all interactions).

conclusionsAmong persons with CKD, several kidney tubule biomarkers are associated with higher risk of AEs during hypertension treatment, independent of eGFR and albuminuria.

Indexed as

Acute Kidney InjuryHypertensionRenal Insufficiency, ChronicAgedAged, 80 and overAlbuminuriaBiomarkersBlood PressureGlomerular Filtration RateHumansKidney TubulesLipocalin-2Middle AgedMineralsUromodulinBiomarkersLipocalin-2MineralsUromodulinadverse eventsbiomarkerschronic kidney diseasehypertensionkidney tubule

Identifiers

PMID34473302
PMCPMC9649818
OpenAlexW3197235273

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.