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13 records – page 1 of 2.

Accuracy of GFR estimating equations combining standardized cystatin C and creatinine assays: a cross-sectional study in Sweden.

https://arctichealth.org/en/permalink/ahliterature270880
Source
Clin Chem Lab Med. 2015 Feb;53(3):403-14
Publication Type
Article
Date
Feb-2015
Author
Jonas Björk
Anders Grubb
Anders Larsson
Lars-Olof Hansson
Mats Flodin
Gunnar Sterner
Veronica Lindström
Ulf Nyman
Source
Clin Chem Lab Med. 2015 Feb;53(3):403-14
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Cohort Studies
Creatinine - blood
Cross-Sectional Studies
Cystatin C - blood
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Renal Insufficiency, Chronic - blood - epidemiology
Sweden - epidemiology
Young Adult
Abstract
The recently established international cystatin C calibrator makes it possible to develop non-laboratory specific glomerular filtration rate (GFR) estimating (eGFR) equations. This study compares the performance of the arithmetic mean of the revised Lund-Malmö creatinine and CAPA cystatin C equations (MEANLM-REV+CAPA), the arithmetic mean of the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) creatinine and cystatin C equations (MEANCKD-EPI), and the composite CKD-EPI equation (CKD-EPICREA+CYSC) with the corresponding single marker equations using internationally standardized calibrators for both cystatin C and creatinine.
The study included 1200 examinations in 1112 adult Swedish patients referred for measurement of GFR (mGFR) 2008-2010 by plasma clearance of iohexol (median 51 mL/min/1.73 m2). Bias, precision (interquartile range, IQR) and accuracy (percentage of estimates ±30% of mGFR; P30) were compared.
Combined marker equations were unbiased and had higher precision and accuracy than single marker equations. Overall results of MEANLM-REV+CAPA/MEANCKD-EPI/CKD-EPICREA+CYSC were: median bias -2.2%/-0.5%/-1.6%, IQR 9.2/9.2/8.8 mL/min/1.73 m2, and P30 91.3%/91.0%/91.1%. The P30 figures were about 7-14 percentage points higher than the single marker equations. The combined equations also had a more stable performance across mGFR, age and BMI intervals, generally with P30 =90% and never
PubMed ID
25274955 View in PubMed
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Accuracy of GFR estimating equations in a large Swedish cohort: implications for radiologists in daily routine and research.

https://arctichealth.org/en/permalink/ahliterature280255
Source
Acta Radiol. 2017 Mar;58(3):367-375
Publication Type
Article
Date
Mar-2017
Author
Ulf Nyman
Anders Grubb
Veronica Lindström
Jonas Björk
Source
Acta Radiol. 2017 Mar;58(3):367-375
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cohort Studies
Contrast Media - pharmacokinetics
Female
Glomerular Filtration Rate - physiology
Humans
Iohexol - pharmacokinetics
Kidney Function Tests - methods - statistics & numerical data
Male
Middle Aged
Radiologists
Radiology
Reproducibility of Results
Research
Sweden
Young Adult
Abstract
Background Guidelines recommend estimation of glomerular filtration rate (eGFR) prior to iodine contrast media (CM) examinations. It is also recommended that absolute eGFR in mL/min, not commonly used relative GFR (adjusted to body surface area; mL/min/1.73?m(2)), should be preferred when dosing and evaluating toxicity of renally excreted drugs. Purpose To validate the absolute Lund-Malmö equation (LM-ABS) in comparison with the absolute Cockcroft-Gault (CG) equation and the relative equations, revised Lund-Malmö (LM-REV), MDRD, and CKD-EPI, after converting relative estimates to absolute values, and to analyze change in eGFR classification when absolute instead of relative eGFR was used. Material and Methods A total of 3495 plasma clearance of iohexol to measure GFR (mGFR) served as reference test. Bias, precision, and accuracy (percentage of estimates ±30% of mGFR; P30) were compared overall and after stratification for various mGFR, eGFR, age, and BMI subgroups. Results The overall P30 results of CG/LM-ABS/LM-REV/MDRD/CKD-EPI were 62.8%/84.9%/83.7%/75.3%/75.6%, respectively. LM-ABS was the most stable equations across subgroups and the only equation that did not exhibit marked overestimation in underweight patients. For patients with relative eGFR 30-44 and 45-59?mL/min/1.73?m(2), 36% and 58% of men, respectively, and 24% and 32% of women, respectively, will have absolute eGFR values outside these relative eGFR intervals. Conclusion Choosing one equation to estimate GFR prior to contrast medium examinations, LM-ABS may be preferable. Unless absolute instead of relative eGFR are used, systematic inaccuracies in assessment of renal function may occur in daily routine and research on CM nephrotoxicity may be flawed.
PubMed ID
27166345 View in PubMed
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The CKD-EPI and MDRD equations to estimate GFR. Validation in the Swedish Lund-Malmö Study cohort.

https://arctichealth.org/en/permalink/ahliterature138119
Source
Scand J Clin Lab Invest. 2011 Apr;71(2):129-38
Publication Type
Article
Date
Apr-2011
Author
Ulf Nyman
Anders Grubb
Gunnar Sterner
Jonas Björk
Author Affiliation
University of Lund, Department of Radiology, Lasarettet Trelleborg, Trelleborg, Sweden. ulf.nyman@skane.se
Source
Scand J Clin Lab Invest. 2011 Apr;71(2):129-38
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Bias (epidemiology)
Body mass index
Child
Child, Preschool
Cohort Studies
Diet
Female
Glomerular Filtration Rate - physiology
Humans
Kidney Failure, Chronic - epidemiology - physiopathology
Male
Middle Aged
Sweden
Young Adult
Abstract
To compare the recently developed CKD-EPI equation to estimate GFR in adult Swedish-Caucasians with the MDRD equation.
Swedish-Caucasians (N = 850, 376 females; median age 60, range 5-95 years) referred for plasma iohexol-clearance (median 55, range 5-223 mL/min/1.73 m²) constituted the Lund-Malmö Study cohort. Bias, precision (interquartile range, IQR, of the differences between estimated and measured GFR), accuracy expressed as percentage of estimates ±10% (P10) and ±30% (P30) of measured GFR, and classification ability for five GFR stages
PubMed ID
21208031 View in PubMed
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Comparison of glomerular filtration rate estimating equations derived from creatinine and cystatin C: validation in the Age, Gene/Environment Susceptibility-Reykjavik elderly cohort.

https://arctichealth.org/en/permalink/ahliterature286484
Source
Nephrol Dial Transplant. 2017 Oct 05;
Publication Type
Article
Date
Oct-05-2017
Author
Jonas Björk
Anders Grubb
Vilmundur Gudnason
Olafur S Indridason
Andrew S Levey
Runolfur Palsson
Ulf Nyman
Source
Nephrol Dial Transplant. 2017 Oct 05;
Date
Oct-05-2017
Language
English
Publication Type
Article
Abstract
Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMR+CAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCr+Cys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPICr and CKD-EPICr+Cys).
A total of 805 individuals, 74-93?years of age, underwent measurement of GFR (mGFR) using plasma clearance of iohexol. Four metrics were used to compare the performance of the GFR equations: bias, precision, accuracy [including the percentage of participants with estimated GFR (eGFR) within 30% of mGFR (P30)] and the ability to detect mGFR?90%. LMRCr and FASCr yielded significantly higher precision and P30 than CKD-EPICr, while bias was significantly worse. LMRCr, FASCr and CKD-EPICr showed similar ability to detect mGFR?
PubMed ID
29040701 View in PubMed
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Glomerular filtration rate in patients with atrial fibrillation on warfarin treatment: A subgroup analysis from the AURICULA registry in Sweden.

https://arctichealth.org/en/permalink/ahliterature101012
Source
Thromb Res. 2011 May 25;
Publication Type
Article
Date
May-25-2011
Author
Karl M Jönsson
Mattias Wieloch
Gunnar Sterner
Ulf Nyman
Sölve Elmståhl
Gunnar Engström
Peter J Svensson
Author Affiliation
University of Lund, Sweden; Department of Coagulation Disorders, Skåne University Hospital, Malmö, Sweden.
Source
Thromb Res. 2011 May 25;
Date
May-25-2011
Language
English
Publication Type
Article
Abstract
INTRODUCTION: Numerous associations between chronic kidney disease (CKD) and atrial fibrillation (AF) have been reported and patients with CKD on anticoagulation therapy have an increased risk of bleeding. Currently, new anticoagulant agents are emerging in clinical practice, some of which are excreted by the kidneys. The proportion of AF patients on anticoagulant treatment with reduced renal function is, however, unknown. MATERIALS AND METHODS: Using AURICULA, a Swedish registry for anticoagulation, estimated glomerular filtration rate (eGFR) was investigated in AF patients on warfarin treatment (n=2,603). The study group was compared with a healthy sample from the population (n=2,261). Two different creatinine prediction equations were used for calculating eGFR: the Lund-Malmö (LM) and MDRD Study equation. RESULTS: The fraction of AF patients with eGFR
PubMed ID
21620441 View in PubMed
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A new tool for predicting the probability of chronic kidney disease from a specific value of estimated GFR.

https://arctichealth.org/en/permalink/ahliterature142890
Source
Scand J Clin Lab Invest. 2010 Sep;70(5):327-33
Publication Type
Article
Date
Sep-2010
Author
Jonas Björk
Anders Grubb
Gunnar Sterner
Ulf Nyman
Author Affiliation
Competence Centre for Clinical Research, Lund University Hospital, Lund, Sweden.
Source
Scand J Clin Lab Invest. 2010 Sep;70(5):327-33
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Female
Glomerular Filtration Rate
Humans
Iohexol - diagnostic use
Kidney Failure, Chronic - diagnosis - epidemiology
Logistic Models
Male
Prevalence
Probability
Renal Insufficiency, Chronic - diagnosis - epidemiology
Sweden - epidemiology
Abstract
To demonstrate how patients' probability of having chronic kidney disease (CKD) stage 3-5 (measured GFR 90% only when eGFR is 90% already when eGFR is 59 mL/min/1.73 m(2) in a screening population, whereas it is 88 mL/min/1.73 m(2) in a CKD population.
Instead of reporting diagnostic accuracy as sensitivity, specificity, and predictive values, actual eGFR supplemented with the probability that it represents a true GFR
PubMed ID
20545460 View in PubMed
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The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population.

https://arctichealth.org/en/permalink/ahliterature258588
Source
Clin Chem Lab Med. 2014 Jun;52(6):815-24
Publication Type
Article
Date
Jun-2014
Author
Ulf Nyman
Anders Grubb
Anders Larsson
Lars-Olof Hansson
Mats Flodin
Gunnar Nordin
Veronica Lindström
Jonas Björk
Source
Clin Chem Lab Med. 2014 Jun;52(6):815-24
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Body mass index
Cohort Studies
Creatinine - blood
Female
Glomerular Filtration Rate
Humans
Iohexol - pharmacokinetics
Kidney Function Tests - methods
Male
Middle Aged
Renal Insufficiency, Chronic - blood - physiopathology
Sex Factors
Sweden
Young Adult
Abstract
The performance of creatinine-based glomerular filtration rate (GFR) estimating equations may vary in subgroups defined by GFR, age and body mass index (BMI). This study compares the performance of the Modification of Diet in Renal Disease (MDRD) study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations with the revised Lund-Malmö equation (LM Revised), a new equation that can be expected to handle changes in GFR across the life span more accurately.
The study included 3495 examinations in 2847 adult Swedish patients referred for measurement of GFR (mGFR) 2008-2010 by plasma clearance of iohexol (median 52 mL/min/1.73 m²). Bias, precision [interquartile range (IQR)] and accuracy [percentage of estimates ±10% (P10) and ±30% (P30) of mGFR] were compared.
The overall results of LM Revised/MDRD/CKD-EPI were: median bias 2%/8%/11%, IQR 12/14/14 mL/min/1.73 m², P10 40%/35%/35% and P30 84%/75%/76%. LM Revised was the most stable equation in terms of bias, precision and accuracy across mGFR, age and BMI intervals irrespective of gender. MDRD and CKD-EPI overestimated mGFR in patients with decreased kidney function, young adults and elderly. All three equations overestimated mGFR and had low accuracy in patients with BMI
PubMed ID
24334413 View in PubMed
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Subclinical hypercortisolism and CT appearance in adrenal incidentalomas: a multicenter study from Southern Sweden.

https://arctichealth.org/en/permalink/ahliterature126833
Source
Endocrine. 2012 Aug;42(1):164-73
Publication Type
Article
Date
Aug-2012
Author
Henrik Olsen
Erik Nordenström
Anders Bergenfelz
Ulf Nyman
Stig Valdemarsson
Erik Palmqvist
Author Affiliation
Department of Internal Medicine, Hospital of Helsingborg, 251 87, Helsingborg, Sweden. henrik.olsen@skane.se
Source
Endocrine. 2012 Aug;42(1):164-73
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adrenal Gland Neoplasms - blood - complications - epidemiology - radiography
Adrenocorticotropic Hormone - blood
Adult
Aged
Aged, 80 and over
Asymptomatic Diseases - epidemiology
Cushing Syndrome - blood - complications - epidemiology - radiography
Dehydroepiandrosterone Sulfate - blood
Female
Humans
Hydrocortisone - blood
Hypertension - blood - complications - epidemiology
Male
Middle Aged
Sweden - epidemiology
Tomography, X-Ray Computed - statistics & numerical data
Abstract
Evaluation of subclinical hypercortisolism (SH) in patients with adrenal incidentaloma (AI) including its correlation to size, attenuation at unenhanced computed tomography (CT) and unilateral or bilateral adrenal disease. Nine hospitals in Southern Sweden investigated during 2005-2007 consecutively patients with AI with hormonal and CT examinations according a regional protocol. Two hundred and twenty-eight patients with AI with median size 2.0 cm were included. One mg overnight dexamethasone suppression test (DST) was performed in 223 patients and basal P-ACTH measured in 146 patients. SH was defined as cortisol = 50 nmol/l at DST in combination with basal ACTH
Notes
Comment In: Endocrine. 2012 Aug;42(1):7-822588953
PubMed ID
22350586 View in PubMed
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Torsten Almén (1931-2016): the father of non-ionic iodine contrast media.

https://arctichealth.org/en/permalink/ahliterature279611
Source
Acta Radiol. 2016 Sep;57(9):1072-8
Publication Type
Article
Date
Sep-2016
Author
Ulf Nyman
Olle Ekberg
Peter Aspelin
Source
Acta Radiol. 2016 Sep;57(9):1072-8
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Animals
Contrast Media - chemistry - history
History, 20th Century
History, 21st Century
Humans
Iodine - chemistry
Osmolar Concentration
Radiology - history
Sweden
Abstract
The Swedish radiologist Torsten Almén is the first clinical radiologist ever to have made a fundamental contribution to intravascular contrast medium design, the development of non-ionic contrast media. He became emotionally triggered by the patients' severe pain each time he injected the ionic "high-osmolar" contrast media when performing peripheral arteriographies in the early 1960s. One day he got a flash of genius that combined the observation of pain, a pathophysiological theory and how to eliminate it with suitable contrast media chemistry. After self-studies in chemistry he developed the concept of iodine contrast media not dissociating into ions in solution to reduce their osmolality and even reach plasma isotonicity. He offered several pharmaceutical companies his concept of mono- and polymeric non-ionic agents but without response, since it was considered against the chemical laws of that time. Contrast media constructed as salts and dissociating into ions in solution was regarded an absolute necessity to achieve high enough water solubility and concentration for diagnostic purposes. Finally a small Norwegian company, Nyegaard & Co., took up his idea 1968 and together they developed the essentially painless "low-osmolar" monomeric non-ionic metrizamide (Amipaque) released in 1974 and iohexol (Omipaque) in 1982 followed by the "iso-osmolar" dimeric non-ionic iodixanol (Visipaque) released in 1993. This has implied a profound paradigm shift with regard to reduction of both hypertonic and chemotoxic side effects, which have been a prerequisite for the today's widespread use of contrast medium-enhanced CT and advanced endovascular interventional techniques even in fragile patients.
PubMed ID
27225455 View in PubMed
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13 records – page 1 of 2.