Evidence mapPaperPMID 37768547Full record

Observational studyJournal of nephrology2023

Loop diuretics improve conditions of dialysis inception in advanced CKD: an observational cohort study.

Dogan-Firat Bozman, Dorothée Bazin, Frédéric Lavainne, Aghiles Hamroun, Cécile Couchoud, Thierry Hannedouche, on the REIN registry

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 44% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

7 authors at 5 institutions in 1 country.

Dogan-Firat BozmanDepartment of Nephrology, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67 000, Strasbourg, France.
Dorothée BazinDepartment of Nephrology, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67 000, Strasbourg, France.
Frédéric LavainnePôle Santé Atlantique-Association ECHO, Avenue Claude Bernard, 44800, Saint-Herblain, France.
Aghiles HamrounDepartment of Nephrology, CHRU Lille, Rue Polonovski, 59800, Lille, France.
Cécile CouchoudAgence de Biomédecine, Registre REIN, 1 Avenue du Stade de France, 93212, Saint Denis La Plaine Cedex, France.
Thierry HannedoucheAURAL Strasbourg, 5 Rue Henri Bergson, 67200, Strasbourg, France. thannedouche@unistra.fr.ORCID 0000-0002-8493-8260
on the REIN registry
Hôpitaux Universitaires de Strasbourg · FRAgence de la Biomédecine · FRAssociation pour l'Utilisation du Rein Artificiel · FRCentre Hospitalier Universitaire de Lille · FRUniversité Claude Bernard Lyon 1 · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiuretics can reduce fluid overload but their effects on conditions of dialysis start remain elusive. We aimed to determine whether loop diuretics exposure in the year before inception can delay the need for dialysis, affect the conditions of dialysis start, and cause early mortality three months after initiation in pre-dialysis patients.

methodsAll adult patients starting dialysis from 2009 to 2015 in the REIN registry were included. Three subgroups were defined according to diuretics exposure: "continuous", "stopped", or "no diuretics" over the year before inception and compared for pre-dialysis hospitalization rates, and 3-month mortality after dialysis.

resultsAmong 59,302 patients, we found fewer emergency initiations of dialysis in the continuous diuretics group than in the stopped diuretics and no diuretics groups: 9492 (27.5%) vs 1905 (32.3%) and 5226 (35.0%), respectively; p < 0.0001. In the continuous diuretics group, there were fewer starts on central venous catheters than in the stopped diuretics and no diuretics groups: 16,677 (49.4%) vs. 3246 (56.0%) vs. 8,639 (58.4%); p < 0.0001. Patients with continuous diuretic exposure had a lower hospitalization rate than the stopped diuretics group in the year prior to dialysis, except for heart failure. The unadjusted 3-month hazard ratio of mortality after dialysis inception was significantly higher in the "no diuretics" or "stopped diuretics" groups compared with "continuous diuretics", but the excess of risk was blunted after adjustment for emergency start and pre-dialysis visits to a nephrologist.

conclusionContinuous loop diuretics exposure in the year before dialysis was associated with better conditions of dialysis inception, and possibly lower mortality rates in the three months after inception.

Indexed as

Heart FailureRenal Insufficiency, ChronicAdultCohort StudiesDialysisDiureticsHumansSodium Potassium Chloride Symporter InhibitorsDiureticsSodium Potassium Chloride Symporter InhibitorsDialysis inceptionEmergency startFluid overloadHeart failureHospitalizationsLoop diureticsSurvival

Identifiers

PMID37768547
OpenAlexW4387115895

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.