Evidence mapPaperPMID 41068513Full record

ArticleInternational urology and nephrology2026

Cardiovascular implications of osmotic changes during hemodialysis: a potential risk factor.

Kamila Bołtuć-Dziugieł, Robert Dziugieł, Joanna Roskal-Wałek, Agnieszka Bociek, Sylwia Terpiłowska, Wojciech Dąbrowski, Andrzej Jaroszyński

Abstract read
In one paragraph

Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Kamila Bołtuć-DziugiełCollegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland. kbdziugiel@gmail.com.ORCID http://orcid.org/0000-0001-7592-656X
Robert DziugiełCollegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.ORCID http://orcid.org/0000-0003-0401-9406
Joanna Roskal-WałekCollegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.ORCID http://orcid.org/0000-0002-9658-5909
Agnieszka BociekCollegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.ORCID http://orcid.org/0000-0002-0356-8211
Sylwia TerpiłowskaDepartment of Surgical Medicine with the Laboratory of Medical Genetics, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.ORCID http://orcid.org/0000-0002-2988-9443
Wojciech DąbrowskiFirst Department of Anesthesiology and Intensive Care, University Hospital No. 4, 20-090, Lublin, Poland.ORCID http://orcid.org/0000-0003-0449-2375
Andrzej JaroszyńskiCollegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.ORCID http://orcid.org/0000-0001-8194-1723

Funding

Jan Kochanowski University, Kielce, Poland SUPB.RN.23.025
6 · The paper itself

Abstract

purposeEnd-stage renal disease (ESRD) patients undergoing hemodialysis (HD) face a significantly higher risk of cardiovascular-related mortality compared to the general population. Osmotic stress, defined as the strain caused by rapid shifts in plasma solute concentration, occurs during HD and places additional burden on the cardiovascular system. Our study aimed to assess the effect of this HD-induced osmotic stress on cardiovascular parameters.

methodsA total of 46 ESRD patients treated with HD were included in the study. For each patient, plasma osmolality, blood pressure, digital electrocardiography, and subendocardial viability ratio (SEVR) were measured before and after a single HD session.

resultsPlasma osmolality decreased by 18.59 mOsm/kg (5.8%) after a single HD session (p < 0.0001), reflecting HD-related osmotic stress. A prolongation of the corrected QT (QTc) interval by 8.0 ms (p = 0.0001) and an improvement in SEVR by 14.5% (p = 0.0004) were also observed. Changes in plasma osmolality correlated with alterations in QTc interval (r = 0.434, p = 0.005), urea (r = 0.461, p = 0.002), and SEVR (r = - 0.439, p = 0.004), among others. Multiple regression analysis identified osmolality change as an independent predictor of SEVR and QTc interval changes. Interestingly, changes in urea were not significant, possibly due to urea rebound or other osmotic factors.

conclusionOur study revealed that changes in plasma osmolality are reliable predictors of the QTc interval and SEVR. Interestingly, changes in urea were not significant, possibly due to the phenomenon of "urea rebound" or the influence of other osmotic factors. Hemodialysis-related osmotic changes appear to affect cardiovascular parameters, potentially predisposing patients to cardiac events.

Indexed as

Cardiovascular DiseasesKidney Failure, ChronicOsmotic PressureRenal DialysisAdultAgedBlood PressureElectrocardiographyFemaleHumansMaleMiddle AgedOsmolar ConcentrationRisk FactorsUreaUreaCardiovascular parametersHemodialysisOsmotic stressQTc interval

Identifiers

PMID41068513
PMCPMC12999842

What Socratic holds

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Registered trials

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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.