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Accepting kidneys from older living donors: impact on transplant recipient outcomes.

https://arctichealth.org/en/permalink/ahliterature136196
Source
Am J Transplant. 2011 Apr;11(4):743-50
Publication Type
Article
Date
Apr-2011
Author
A. Young
S J Kim
M R Speechley
A. Huang
G A Knoll
G V Ramesh Prasad
D. Treleaven
M. Diamant
A X Garg
Author Affiliation
Division of Nephrology, University of Western Ontario, Canada. ann.young@lhsc.on.ca
Source
Am J Transplant. 2011 Apr;11(4):743-50
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Cadaver
Canada
Cohort Studies
Female
Follow-Up Studies
Glomerular Filtration Rate
Graft Rejection
Humans
Kidney - physiopathology - surgery
Kidney Function Tests
Kidney Transplantation - mortality
Living Donors
Male
Medical Records
Middle Aged
Registries
Retrospective Studies
Tissue and Organ Procurement
Young Adult
Abstract
Older living kidney donors are regularly accepted. Better knowledge of recipient outcomes is needed to inform this practice. This retrospective cohort study observed kidney allograft recipients from Ontario, Canada between January 2000 and March 2008. Donors to these recipients were older living (= 60 years), younger living, or standard criteria deceased (SCD). Review of medical records and electronic healthcare data were used to perform survival analysis. Recipients received 73 older living, 1187 younger living and 1400 SCD kidneys. Recipients of older living kidneys were older than recipients of younger living kidneys. Baseline glomerular filtration rate (eGFR) of older kidneys was 13 mL/min per 1.73 m² lower than younger kidneys. Median follow-up time was 4 years. The primary outcome of total graft loss was not significantly different between older and younger living kidney recipients [adjusted hazard ratio, HR (95%CI): 1.56 (0.98-2.49)]. This hazard ratio was not proportional and increased with time. Associations were not modified by recipient age or donor eGFR. There was no significant difference in total graft loss comparing older living to SCD kidney recipients [HR: 1.29 (0.80-2.08)]. In light of an observed trend towards potential differences beyond 4 years, uncertainty remains, and extended follow-up of this and other cohorts is warranted.
PubMed ID
21401866 View in PubMed
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Access to health care among status Aboriginal people with chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature154422
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Publication Type
Article
Date
Nov-4-2008
Author
Song Gao
Braden J Manns
Bruce F Culleton
Marcello Tonelli
Hude Quan
Lynden Crowshoe
William A Ghali
Lawrence W Svenson
Sofia Ahmed
Brenda R Hemmelgarn
Author Affiliation
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, AB.
Source
CMAJ. 2008 Nov 4;179(10):1007-12
Date
Nov-4-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Chronic Disease
Creatinine - blood
Delphi Technique
Female
Glomerular Filtration Rate
Health Services Accessibility
Healthcare Disparities
Humans
Indians, North American - statistics & numerical data
Kidney Diseases - epidemiology
Male
Middle Aged
Nephrology
Office visits - statistics & numerical data
Patient Admission - statistics & numerical data
Registries
Severity of Illness Index
Abstract
Ethnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada. We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease.
We identified 106 511 non-Aboriginal and 1182 Aboriginal patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL/min/1.73 m(2)). We compared outcomes, including hospital admissions, that may have been preventable with appropriate outpatient care (ambulatory-care-sensitive conditions) as well as use of specialist services, including visits to nephrologists and general internists.
Aboriginal people were almost twice as likely as non-Aboriginal people to be admitted to hospital for an ambulatory-care-sensitive condition (rate ratio 1.77, 95% confidence interval [CI] 1.46-2.13). Aboriginal people with severe chronic kidney disease (estimated glomerular filtration rate
Notes
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Comment In: CMAJ. 2008 Nov 4;179(10):985-618981431
PubMed ID
18981441 View in PubMed
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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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Accurate assessment of kidney function in indigenous Australians: the estimated GFR study.

https://arctichealth.org/en/permalink/ahliterature121702
Source
Am J Kidney Dis. 2012 Oct;60(4):680-2
Publication Type
Article
Date
Oct-2012
Author
Louise J Maple-Brown
Jaquelyne T Hughes
Paul D Lawton
Graham R D Jones
Andrew G Ellis
Katrina Drabsch
Alex D H Brown
Alan Cass
Wendy E Hoy
Richard J MacIsaac
Kerin O'Dea
George Jerums
Author Affiliation
Menzies School of Health Research, Darwin, Australia. louise.maple-brown@menzies.edu.au
Source
Am J Kidney Dis. 2012 Oct;60(4):680-2
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Glomerular Filtration Rate
Humans
Iohexol - metabolism
Oceanic Ancestry Group
Reproducibility of Results
Notes
Erratum In: Am J Kidney Dis. 2013 Mar;61(3):527-8
PubMed ID
22884671 View in PubMed
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Acetaminophen, aspirin and progression of advanced chronic kidney disease.

https://arctichealth.org/en/permalink/ahliterature153050
Source
Nephrol Dial Transplant. 2009 Jun;24(6):1908-18
Publication Type
Article
Date
Jun-2009
Author
Marie Evans
Carl Michael Fored
Rino Bellocco
Garrett Fitzmaurice
Jon P Fryzek
Joseph K McLaughlin
Olof Nyrén
Carl-Gustaf Elinder
Author Affiliation
Nephrology Unit, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet and University Hospital, Stockholm, Sweden. marie.evans@ki.se
Source
Nephrol Dial Transplant. 2009 Jun;24(6):1908-18
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Acetaminophen - administration & dosage - adverse effects
Adult
Aged
Analgesics, Non-Narcotic - administration & dosage - adverse effects
Aspirin - administration & dosage - adverse effects
Cohort Studies
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic - etiology - physiopathology - therapy
Male
Middle Aged
Renal Replacement Therapy
Sweden
Time Factors
Abstract
Although many studies have investigated the possible association between analgesic use (acetaminophen and aspirin) and the development of chronic kidney disease (CKD), the effect of analgesics on the progression of established CKD of any cause has not yet been investigated.
In this population-based Swedish cohort study, we investigated the decline over 5-7 years in estimated glomerular filtration rate (eGFR) among 801 patients with incident, advanced CKD (serum creatinine >3.4 mg/dL for men, >2.8 mg/dL for women for the first time) and with different analgesic exposures. Lifetime analgesic use and current regular use were ascertained through in-person interviews at inclusion while data on analgesic use during the follow-up was abstracted from the medical records at the end of the study period. A linear regression slope, based on their eGFR values during the follow-up, provided a summary of within-individual change. In the final multivariate analyses, a linear mixed effects model was implemented to assess the relation of analgesic use and change in eGFR over time.
The progression rate for regular users of acetaminophen was slower than that for non-regular users (regular users progressed 0.93 mL/min/1.73 m(2) per year slower than non-regular users; 95% CI 0.03, 1.8). For regular users of aspirin, the progression rate was significantly slower than that for non-regular users (regular users progressed 0.80 mL/min/1.73 m(2) per year slower than non-regular users; 95% CI 0.1, 1.5). Different levels of lifetime cumulative dose of acetaminophen and aspirin did not significantly affect the progression rate.
We suggest that single substance acetaminophen and aspirin may be safe to use by patients with diagnosed advanced CKD stage 4-5 without an adverse effect on the progression rate of the disease.
PubMed ID
19155536 View in PubMed
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[A clinic for prevention of progression of kidney failure].

https://arctichealth.org/en/permalink/ahliterature164390
Source
J Ren Care. 2006 Jul-Sep;32(3):153-6
Publication Type
Article
Author
A. Brousseau
Author Affiliation
Centre Hospitalier Ambulatoire Régionale de Laval, Québec, Kanada. abrousse_charl@ssss.gouv.qc.ca
Source
J Ren Care. 2006 Jul-Sep;32(3):153-6
Language
German
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Albuminuria - diagnosis - prevention & control
Body mass index
Canada - epidemiology
Disease Progression
Exercise
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension - epidemiology - prevention & control
Kidney Failure, Chronic - diagnosis - epidemiology - prevention & control - therapy
Male
Middle Aged
Outpatient Clinics, Hospital
Patient care team
Patient Education as Topic
Peritoneal dialysis
Primary Prevention
Quebec
Renal Dialysis
Smoking Cessation
Time Factors
Abstract
Prevention in nephrology is only possible with the cooperation of patients and their families. The nurse plays a considerable role in working with patients and is a major player in the team, responsible for follow-up of the patient, where the earliest interventions can help delay and sometimes avoid dialysis. The hypertension clinic is the beginning of a continuum until dialysis. This paper describes three clinics that are managed in the renal service and indicates how they contribute to offering optimal care to a renal population.
PubMed ID
17393810 View in PubMed
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Acute kidney injury after coronary artery bypass grafting and long-term risk of myocardial infarction and death.

https://arctichealth.org/en/permalink/ahliterature258575
Source
Int J Cardiol. 2014 Mar 1;172(1):190-5
Publication Type
Article
Date
Mar-1-2014
Author
Linda Rydén
Staffan Ahnve
Max Bell
Niklas Hammar
Torbjörn Ivert
Ulrik Sartipy
Martin J Holzmann
Source
Int J Cardiol. 2014 Mar 1;172(1):190-5
Date
Mar-1-2014
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - mortality
Aged
Aged, 80 and over
Coronary Artery Bypass - adverse effects - mortality
Creatinine - blood
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - metabolism - mortality - surgery
Prognosis
Proportional Hazards Models
Registries - statistics & numerical data
Risk factors
Sweden - epidemiology
Abstract
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with early mortality. Its impact on the risk of myocardial infarction (MI) over time and long-term mortality has not been well described.
We performed a nationwide population-based cohort study in 27,929 patients who underwent a first isolated CABG between 2000 and 2008 in Sweden. Acute kidney injury was divided into three categories based on the absolute increase in postoperative serum creatinine (sCr) concentration compared with the preoperative baseline: stage 1, sCr increase of 0.3 to 0.5mg/dL; stage 2, sCr increase of >0.5 to 1.0mg/dL and stage 3, sCr increase of = 1.0mg/dL.
The overall incidence of postoperative AKI was 13%, 6.3% met the criterion for stage 1, 4.3% for stage 2 and 2.3% for stage 3. During a mean follow-up of 5.0 years, there were 2119 (7.6%) MIs and 4679 (17%) deaths. Multivariable adjusted hazard ratios with 95% confidence intervals for MI were 1.35 (1.15 to 1.57), 1.80 (1.53 to 2.13) and 1.63 (1.29 to 2.07), in AKI stages 1, 2 and 3, respectively. The corresponding hazard ratios for all-cause mortality were 1.30 (1.17 to 1.44), 1.65 (1.48 to 1.83) and 2.68 (2.37 to 3.03), respectively.
Our results show that AKI after CABG is associated with an increased long-term risk of MI and death.
PubMed ID
24502882 View in PubMed
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Acute kidney injury and long-term risk of stroke after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature107407
Source
Int J Cardiol. 2013 Oct 15;168(6):5405-10
Publication Type
Article
Date
Oct-15-2013
Author
Martin J Holzmann
Linda Rydén
Ulrik Sartipy
Author Affiliation
Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: martin.holzmann@karolinska.se.
Source
Int J Cardiol. 2013 Oct 15;168(6):5405-10
Date
Oct-15-2013
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - epidemiology - mortality
Age Distribution
Aged
Cerebral Hemorrhage - epidemiology - mortality
Coronary Artery Bypass - adverse effects - mortality
Coronary Artery Disease - epidemiology - mortality - surgery
Female
Follow-Up Studies
Glomerular Filtration Rate
Heart Failure - epidemiology - mortality
Humans
Incidence
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries - statistics & numerical data
Risk factors
Sex Distribution
Stroke - epidemiology - mortality
Sweden - epidemiology
Abstract
Acute kidney injury (AKI) is associated with death, end-stage renal disease, and heart failure in patients with coronary heart disease. This study investigated the association between AKI and long-term risk of stroke.
50,244 patients who underwent coronary artery bypass grafting (CABG) in Sweden between 2000 and 2008 were identified from the SWEDEHEART registry. After exclusions 23,584 patients without prior stroke who underwent elective, primary, isolated, CABG were included. AKI was categorized according to absolute increases in postoperative creatinine values compared with preoperative values: stage 1, 0.3-0.5 mg/dL (26-44 µmol/L); stage 2, 0.5-1.0mg/dL (44-88 µmol/L); and stage 3, >1.0 mg/dL (=88 µmol/L). Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke. There were 1156 (4.9%) strokes during a mean follow-up of 4.1 years. After adjustment for confounders, HRs (95% CIs) for stroke in AKI stages 1, 2 and 3 were 1.12 (0.89-1.39), 1.31 (1.04-1.66) and 1.31 (0.92-1.87), respectively, compared with no AKI. This association disappeared after taking death into account in competing risk analysis. There was a significant association between AKI and stroke in men (HR: 1.26 [1.05-1.50]) but not in women (HR: 1.07 [0.75-1.53]), and in younger (
PubMed ID
24012170 View in PubMed
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Acute kidney injury assessed by cystatin C after transcatheter aortic valve implantation and late renal dysfunction.

https://arctichealth.org/en/permalink/ahliterature267312
Source
J Cardiothorac Vasc Anesth. 2014 Aug;28(4):960-5
Publication Type
Article
Date
Aug-2014
Author
Malin Johansson
Shahab Nozohoor
Henrik Bjursten
Per Ola Kimblad
Johan Sjögren
Source
J Cardiothorac Vasc Anesth. 2014 Aug;28(4):960-5
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - epidemiology - etiology
Aged
Aged, 80 and over
Aortic Valve Stenosis - surgery
Biological Markers - blood
Creatinine - blood
Cystatin C - blood
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Incidence
Kidney - physiopathology
Male
Prognosis
Prospective Studies
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Transcatheter Aortic Valve Replacement - adverse effects
Abstract
The aim of the present study was to evaluate acute kidney injury (AKI) with cystatin C following transcatheter aortic valve implantation (TAVI) and to assess the impact of postoperative AKI on outcome and late renal function.
A prospective study.
Single, tertiary referral center.
Sixty-eight consecutive patients with severe aortic stenosis and advanced comorbidity.
Blood samples were collected on 4 occasions pre- and postoperatively to determine levels of s-creatinine and cystatin C. Additionally, a sample was collected at followup 12 months postoperatively for the determination of s-creatinine.
The mean preoperative eGFR (s-creatinine) was 67±24 mL/min/1.73 m² compared to 45±21 mL/min/1.73 m² with eGFR (cystatin C) (p
PubMed ID
24315756 View in PubMed
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400 records – page 1 of 40.