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Interventions for lowering plasma homocysteine levels in kidney transplant recipients

Overview of attention for article published in Cochrane database of systematic reviews, May 2015
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About this Attention Score

  • Good Attention Score compared to outputs of the same age (70th percentile)

Mentioned by

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5 tweeters
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1 Facebook page

Citations

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7 Dimensions

Readers on

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64 Mendeley
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Title
Interventions for lowering plasma homocysteine levels in kidney transplant recipients
Published in
Cochrane database of systematic reviews, May 2015
DOI 10.1002/14651858.cd007910.pub2
Pubmed ID
Authors

Amy Kang, Sagar U Nigwekar, Vlado Perkovic, Satyarth Kulshrestha, Sophia Zoungas, Sankar D Navaneethan, Alan Cass, Martin P Gallagher, Toshiharu Ninomiya, Giovanni FM Strippoli, Meg J Jardine

Abstract

Elevated homocysteine levels have been shown to be an independent risk factor for cardiovascular disease. However studies of homocysteine lowering in general and end-stage kidney disease (ESKD) populations have not demonstrated a reduction in cardiovascular event rates. Kidney transplant recipients have high homocysteine levels, high cardiovascular event rates and, unlike the ESKD population, may achieve normalisation of homocysteine levels with homocysteine lowering therapies. Thus may benefit from homocysteine lowering therapy. To evaluate the effects of established homocysteine lowering therapy on cardiovascular mortality in patients with functioning kidney transplants. We searched the Cochrane Renal Group's Specialised Register to 16 March 2015 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Randomised controlled trials of any therapy that has been shown to significantly lower homocysteine levels conducted in people with functioning kidney transplants. Studies were to be included if they compared homocysteine lowering therapy with placebo or usual care, or compare higher versus lower doses of homocysteine lowering therapy. Two authors independently assessed study quality and extracted data. Results were to be expressed as the risk ratio (RR) for dichotomous outcomes or mean difference (MD) for continuous outcomes with 95% confidence intervals (CI). Data was to be pooled using the random effects model. The literature search yielded 359 reports of which only one study was identified that met our inclusion criteria and reported relevant clinical endpoints. This study randomised 4110 adult participants with a functioning kidney transplant and elevated homocysteine levels to folic acid plus high dose B multivitamins or low dose multivitamins who were followed for a mean 4.0 years. Despite effectively lowering homocysteine levels) in homocysteine levels at follow-up (MD -4.40 μmol/L, 95% CI -5.98 to -2.82) there was no evidence the intervention impacted on any of the outcomes reported including cardiovascular mortality (RR 0.91, 95% CI 0.69 to 1.20), all-cause mortality (RR 1.04, 95% CI 0.88 to 1.22), myocardial infarction (RR 1.02, 95% CI 0.77 to 1.35), stroke (RR 1.08, 95% CI 0.69 to 1.71), commencement of renal replacement therapy (RR 1.12, 95% CI 0.91 to 1.37) or all reported adverse events (RR 1.02, 95% CI 0.87 to 1.20). There was no evidence the intervention impacted on the primary endpoint of the study, a cardiovascular event composite (RR 0.99, 95% CI 0.85 to 1.15). The study was of high quality. There is no current evidence to support the use of homocysteine lowering therapy for cardiovascular disease prevention in kidney transplant recipients.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Canada 1 2%
Brazil 1 2%
Unknown 61 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 22%
Student > Ph. D. Student 13 20%
Student > Bachelor 11 17%
Researcher 8 13%
Student > Doctoral Student 4 6%
Other 8 13%
Unknown 6 9%
Readers by discipline Count As %
Medicine and Dentistry 25 39%
Nursing and Health Professions 8 13%
Social Sciences 4 6%
Pharmacology, Toxicology and Pharmaceutical Science 3 5%
Biochemistry, Genetics and Molecular Biology 2 3%
Other 9 14%
Unknown 13 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 February 2016.
All research outputs
#3,471,549
of 12,527,219 outputs
Outputs from Cochrane database of systematic reviews
#6,116
of 8,923 outputs
Outputs of similar age
#65,720
of 227,258 outputs
Outputs of similar age from Cochrane database of systematic reviews
#167
of 228 outputs
Altmetric has tracked 12,527,219 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 8,923 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 227,258 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 228 others from the same source and published within six weeks on either side of this one. This one is in the 26th percentile – i.e., 26% of its contemporaries scored the same or lower than it.