Evidence map›Paper›PMID 39774191›Full record

ArticleScientific reports2025

Impact of early initiation of renal replacement therapy in patients on venoarterial ECMO using target trial emulation with Japanese nationwide data.

Toshihiro Kubo, Tomonori Takeuchi, Norihiko Inoue, Augusto Cama-Olivares, Deepak Chandramohan, Ashita J Tolwani, Keith M Wille, Kiyohide Fushimi, Javier A Neyra, Kenji Wakabayashi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Evolution of Clinical Trial Design in ADPKD.Kidney international reports · 2026
    Review
  4. 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

10 authors.

Toshihiro Kubo *Department of Intensive Care Medicine, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Tomonori Takeuchi *Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, THT 647, 1720 2nd Avenue S, Birmingham, AL, 35233, USA.
Norihiko InoueDepartment of Health Policy and Informatics, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Augusto Cama-OlivaresDepartment of Internal Medicine, Brookwood Baptist Health, 833 Princeton Avenue SW, Birmingham, AL, 35211, USA.
Deepak ChandramohanDivision of Nephrology, Department of Medicine, University of Alabama at Birmingham, THT 647, 1720 2nd Avenue S, Birmingham, AL, 35233, USA.
Ashita J TolwaniDivision of Nephrology, Department of Medicine, University of Alabama at Birmingham, THT 647, 1720 2nd Avenue S, Birmingham, AL, 35233, USA.
Keith M WilleDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, 1900 University Blvd, Birmingham, AL, 35294, USA.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
Javier A NeyraDivision of Nephrology, Department of Medicine, University of Alabama at Birmingham, THT 647, 1720 2nd Avenue S, Birmingham, AL, 35233, USA.
Kenji WakabayashiDepartment of Intensive Care Medicine, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan. wakabayashi.ccm@tmd.ac.jp.

Funding

Ministry of Health, Labour and Welfare 22AA2003
6 · The paper itself

Abstract

While renal replacement therapy (RRT) allows for precise fluid management as well as addressing electrolyte imbalances and the removal of other necessary compounds, its early initiation has not shown benefit in the general critically ill population. Moreover, the effects of early RRT initiation specifically in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) also remain unclear. This retrospective study investigated adult patients who underwent VA-ECMO between April 2018 and March 2022 and used the clone-censor-weight method to emulate a hypothetical target trial and compare two groups: patients who initiated RRT within 2 days of VA-ECMO initiation (Early) and those who did not (Late). The primary outcomes were 28-day and 90-day hospital mortality analyzed by Cox proportional hazards models and the secondary outcome was 90-day RRT dependence by pooled logistic regression models. Inverse probability censoring weights were applied to adjust the models. A total of 2,513 VA-ECMO patients were cloned into both groups. The 28-day and 90-day mortalities were lower in the Early group (HR 0.59 [95% CI 0.53-0.68] and 0.67 [0.61-0.75]). However, the early group experienced greater RRT dependence at 90 days than the late group (OR 2.58 [1.94-3.46]). In conclusion, early initiation of RRT (within 2 days of VA-ECMO) was associated with lower hospital mortality but with a higher likelihood of 90-day RRT dependence in adult patients on VA-ECMO.

Indexed as

Extracorporeal Membrane OxygenationHospital MortalityRenal Replacement TherapyAcute Kidney InjuryAdultAgedCritical IllnessEast Asian PeopleFemaleHumansJapanMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesRenal replacement therapyTarget trial emulationVenoarterial extracorporeal membrane oxygenation

Identifiers

PMID39774191
PMCPMC11707199

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.