Skip header and navigation

Refine By

17 records – page 1 of 2.

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
Less detail

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
Less detail

Calculation of glomerular filtration rate expressed in mL/min from plasma cystatin C values in mg/L.

https://arctichealth.org/en/permalink/ahliterature30442
Source
Scand J Clin Lab Invest. 2004;64(1):25-30
Publication Type
Article
Date
2004
Author
A. Larsson
J. Malm
A. Grubb
L O Hansson
Author Affiliation
Department of Medical Sciences, University Hospital, Uppsala, Sweden. anders.larsson@clm.uas.lul.se
Source
Scand J Clin Lab Invest. 2004;64(1):25-30
Date
2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Creatinine - blood - metabolism
Cystatins - blood - metabolism
Female
Glomerular Filtration Rate - physiology
Humans
Iohexol - pharmacokinetics
Kidney - metabolism - physiology
Male
Metabolic Clearance Rate - physiology
Middle Aged
Abstract
The Cockcroft Gault formula is often used to calculate the glomerular filtration rate (GFR) from plasma creatinine results. In Sweden this calculation is not usually done in the laboratory, but locally in the wards. These manual calculations could cause erroneous results. In several studies plasma cystatin C has been shown to be superior to plasma creatinine for estimation of GFR. One limitation of using cystatin C as a GFR marker is that there is no conversion formula transforming cystatin C expressed as mg/L to GFR expressed as mL/min. In this study plasma creatinine and cystatin C were compared with iohexol clearance. A stronger correlation (p
PubMed ID
15025426 View in PubMed
Less detail

Cardiovascular medication in relation to renal function after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature260160
Source
Int J Cardiol. 2013 Oct 9;168(4):4033-8
Publication Type
Article
Date
Oct-9-2013
Author
Ulrik Sartipy
Erik Rampell
Axel C Carlsson
Per Wändell
Martin J Holzmann
Source
Int J Cardiol. 2013 Oct 9;168(4):4033-8
Date
Oct-9-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Agents - pharmacology - therapeutic use
Cohort Studies
Coronary Artery Bypass - adverse effects - trends
Coronary Artery Disease - drug therapy - epidemiology - surgery
Female
Glomerular Filtration Rate - physiology
Humans
Kidney - drug effects - physiology
Male
Middle Aged
Population Surveillance - methods
Retrospective Studies
Sweden - epidemiology
Treatment Outcome
Abstract
Guidelines for recommended medication use for the secondary prevention of coronary heart disease are exceedingly important in patients with chronic kidney disease. Despite a high risk for recurrent cardiovascular events, these patients are less likely to use evidence-based recommended medications. The objective of the current study was to analyze the association between renal function and guideline-recommended drug therapy in patients with coronary heart disease.
In this nationwide population-based cohort study, we included 12,332 patients with established coronary heart disease who underwent primary isolated coronary artery bypass grafting in Sweden between 2005 and 2008. Medication use was retrieved from the national Prescribed Drug Register.
During the first year after coronary surgery, 94% of patients had at least two dispensed prescriptions for an antiplatelet agent, 68% for an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, 92% for a beta-blocker, and 93% for a statin. Only 57% of all patients had prescriptions for all four medication classes. Reduced renal function (estimated glomerular filtration rate (eGFR) of 30 to 45 mL/min per 1.73 m(2) and 60 mL/min per 1.73 m(2)).
In patients with established coronary heart disease, moderate to severe renal dysfunction was associated with significantly lower use of guideline-recommend medications as compared to normal renal function.
PubMed ID
23880581 View in PubMed
Less detail

CKD and risk of hospitalization and death with pneumonia.

https://arctichealth.org/en/permalink/ahliterature150929
Source
Am J Kidney Dis. 2009 Jul;54(1):24-32
Publication Type
Article
Date
Jul-2009
Author
Matthew T James
Hude Quan
Marcello Tonelli
Braden J Manns
Peter Faris
Kevin B Laupland
Brenda R Hemmelgarn
Author Affiliation
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Source
Am J Kidney Dis. 2009 Jul;54(1):24-32
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Chronic Disease
Cohort Studies
Creatinine - blood
Female
Glomerular Filtration Rate - physiology
Hospitalization
Humans
Kidney Diseases - complications - diagnosis - physiopathology
Male
Middle Aged
Pneumonia - mortality
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk factors
Abstract
The effects of kidney disease on the risk of hospitalization or death from specific noncardiovascular causes, including pneumonia, are unclear. The objective of this study is to determine the associations between estimated glomerular filtration rate (eGFR) and hospitalization or death with pneumonia.
Retrospective cohort study.
Community-based study from a Canadian health region of 252,516 participants with 1 or more outpatient serum creatinine measurements from July 1, 2003, to June 30, 2004, who were not receiving dialysis or kidney transplantation.
eGFR calculated by using the 4-variable Modification of Diet in Renal Disease Study equation.
Hospitalization with pneumonia or death within 30 days after pneumonia hospitalization.
Cox proportional hazards models adjusted for age, sex, socioeconomic status, and comorbidities with censoring at death, initiation of renal replacement therapy, or emigration.
Lower eGFR was associated with increased risk of hospitalization with pneumonia, although the magnitude of effect varied with age. The risk associated with decreased eGFR was greatest in participants 18 to 54 years old; compared with participants with an eGFR of 60 to 104 mL/min/1.73 m(2), adjusted hazard ratios for hospitalization with pneumonia were 3.23 (95% confidence interval, 2.40 to 4.36) in those with eGFR of 45 to 59 mL/min/1.73 m(2), 9.67 (95% confidence interval, 6.36 to 14.69) for eGFR of 30 to 44 mL/min/1.73 m(2), and 15.04 (95% confidence interval, 9.64 to 23.47) for eGFR less than 30 mL/min/1.73 m(2). Associations became weaker with increasing age, although the graded inverse association between lower eGFR and risk remained for older participants. An age-dependent inverse relationship also was observed between eGFR and risk of death within 30 days of hospitalization with pneumonia.
Residual confounding caused by severity of illness or unmeasured comorbidities may be present.
The risk of hospitalization and death with pneumonia is greater at lower eGFRs, especially in younger adults. This association may contribute to excess mortality in people with chronic kidney disease.
Notes
Comment In: Am J Kidney Dis. 2009 Jul;54(1):1-319559334
PubMed ID
19447535 View in PubMed
Less detail

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
Less detail

Has the yearly increase in the renal replacement therapy population ended?

https://arctichealth.org/en/permalink/ahliterature108604
Source
J Am Soc Nephrol. 2013 Sep;24(9):1367-70
Publication Type
Article
Date
Sep-2013
Author
Steven Jay Rosansky
William F Clark
Author Affiliation
Dorn Research Institute, WJBD Veterans Affairs Hospital, University of South Carolina School of Public Health, Columbia, USA. sjrcra@yahoo.com
Source
J Am Soc Nephrol. 2013 Sep;24(9):1367-70
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Child
Child, Preschool
Glomerular Filtration Rate - physiology
Humans
Incidence
Infant
Infant, Newborn
Kidney Failure, Chronic - epidemiology - physiopathology - therapy
Middle Aged
Registries
Renal Replacement Therapy - trends
Retrospective Studies
United States - epidemiology
Young Adult
Abstract
The recent decline in the number of new patients undergoing dialysis and transplantation in the United States may be linked to a reduction in the incidence of early-start dialysis, defined as the initiation of renal replacement therapy (RRT) at an estimated GFR =10 ml/min per 1.73 m(2). We examined the most recent data from the U.S. Renal Data System to determine how this trend will affect the future incidence of ESRD in the United States. The percentage of early dialysis starts grew from 19% to 54% of all new starts between 1996 and 2009 but remained stable between 2009 and 2011. Similarly, the incident RRT population increased substantially in all age groups between 1996 and 2005, with the largest increase occurring in patients aged =75 years. Early dialysis starts accounted for most of the increase in the incident RRT population in all age groups during this time period, and between 2005 and 2010, the increase slowed dramatically. Although the future incident RRT population will be determined in part by population growth, these results suggest that later dialysis starts and greater use of conservative and palliative care, which may improve quality of life for elderly patients with advanced renal failure, will continue to attenuate the increase observed in previous years.
Notes
Cites: Kidney Int. 2009 Aug;76(3):257-6119455195
Cites: Nephrol Dial Transplant. 2010 May;25(5):1576-820054027
Cites: Curr Opin Nephrol Hypertens. 2011 May;20(3):241-521422925
Cites: Clin J Am Soc Nephrol. 2011 May;6(5):1222-821555505
Cites: Clin J Am Soc Nephrol. 2012 Jan;7(1):185-9122173860
Cites: Clin J Am Soc Nephrol. 2013 Feb;8(2):265-7023085725
Cites: Clin J Am Soc Nephrol. 2012 Oct;7(10):1664-7222977214
Cites: J Gerontol A Biol Sci Med Sci. 2012 Dec;67(12):1394-923051973
Cites: Clin J Am Soc Nephrol. 2012 Dec;7(12):2049-5722997341
Cites: Clin J Am Soc Nephrol. 2012 Dec;7(12):1924-623221096
Cites: Am J Nephrol. 2012;36(1):1-1022699366
PubMed ID
23868925 View in PubMed
Less detail

Incidence and outcomes of acute kidney injury in a referred chronic kidney disease cohort.

https://arctichealth.org/en/permalink/ahliterature145661
Source
Nephrol Dial Transplant. 2010 Jul;25(7):2203-9
Publication Type
Article
Date
Jul-2010
Author
Jean-Philippe Lafrance
Ognjenka Djurdjev
Adeera Levin
Author Affiliation
Service de Néphrologie, Hôpital Maisonneuve-Rosemont, Montréal, Canada. jean-philippe.lafrance@umontreal.ca
Source
Nephrol Dial Transplant. 2010 Jul;25(7):2203-9
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - epidemiology - physiopathology
Aged
Aged, 80 and over
British Columbia
Chronic Disease
Cohort Studies
Creatinine - blood
Female
Glomerular Filtration Rate - physiology
Humans
Incidence
Kidney Diseases - complications
Kidney Failure, Chronic - diagnosis - epidemiology - physiopathology
Male
Middle Aged
Prognosis
Retrospective Studies
Risk factors
Abstract
Whilst chronic kidney disease (CKD) has been identified as a risk factor for the development of acute kidney injury (AKI), little has been published about the incidence and outcomes of those acute injuries on chronic stable kidney disease and even less in a referred cohort of CKD patients followed up by nephrologists.
We followed up 6862 patients registered as CKD in British Columbia, Canada for a median time of 19.4 months after they achieved an estimated glomerular filtration rate (eGFR) value or =25% compared to a moving baseline eGFR within 25 days.
Of the CKD patients, 44.9% had at least one AKI episode. Crude incidence rate for a first AKI event was 34.8 per 100 person-years. Older age [adjusted relative risks (RR) = 0.93 by 10 years, 95% confidence intervals (CI) = 0.90, 0.95] was associated with a lower risk of AKI. Of the patients, 15.3% died before dialysis and 18.1% initiated dialysis. AKI was associated with both a higher risk of death (adjusted RR = 2.32, 95% CI = 2.04, 2.64) and an increased risk of dialysis (adjusted RR = 2.33, 95% CI = 2.07, 2.61).
In a referred CKD population, AKI was a frequent event and associated with higher risks of dialysis and mortality. The incidence of AKI appears to be less with older age in this population. Quantification of AKI incidence and its risk factors in different populations is important for clinicians and planners, so that appropriate identification, prevention and treatment strategies can be tested.
PubMed ID
20124548 View in PubMed
Less detail

Incidence of nephrogenic systemic fibrosis at a large university hospital in Sweden.

https://arctichealth.org/en/permalink/ahliterature130378
Source
Scand J Urol Nephrol. 2012 Feb;46(1):48-53
Publication Type
Article
Date
Feb-2012
Author
Alaa Alhadad
Gunnar Sterner
Åke Svensson
Hussein Alhadad
Peter Leander
Author Affiliation
Vascular Center, Skåne University Hospital, Malmö, Sweden. alaa.alhadad@gmail.com
Source
Scand J Urol Nephrol. 2012 Feb;46(1):48-53
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Contrast Media - adverse effects
Female
Gadolinium - adverse effects
Glomerular Filtration Rate - physiology
Hospitals, University - statistics & numerical data
Humans
Incidence
Magnetic Resonance Imaging - adverse effects - methods
Male
Middle Aged
Nephrogenic Fibrosing Dermopathy - chemically induced - epidemiology
Renal Dialysis
Renal Insufficiency - pathology - physiopathology - therapy
Retrospective Studies
Sweden - epidemiology
Abstract
Nephrogenic systemic fibrosis (NSF) is a rare condition that may follow administration of gadolinium-based contrast media (Gd-CM) in patients with renal insufficiency. This study was initiated to determine the incidence of NSF at Skåne University Hospital, Malmö, in Sweden.
During the period January 2001 to December 2008 10 650 patients underwent magnetic resonance imaging (MRI) examinations. The re-expressed four-variable Modification of Diet in Renal Disease (MDRD) equation was used to calculate the estimated glomerular filtration rate (eGFR). The 272 patients with an eGFR
PubMed ID
22008005 View in PubMed
Less detail

Patient selection has a strong impact on cystatin C and Modification of Diet in Renal Disease (MDRD) estimated glomerular filtration rate.

https://arctichealth.org/en/permalink/ahliterature92665
Source
Clin Biochem. 2008 Nov;41(16-17):1355-61
Publication Type
Article
Date
Nov-2008
Author
Larsson Anders
Flodin Mats
Hansson Lars-Olof
Carlsson Lena
Author Affiliation
Department of Clinical Chemistry and Pharmacology, University Hospital, Uppsala, Sweden. anders.larsson@akademiska.se
Source
Clin Biochem. 2008 Nov;41(16-17):1355-61
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bias (epidemiology)
Creatinine - blood
Cystatins - blood
Diet
Female
Glomerular Filtration Rate - physiology
Humans
Intensive Care Units
Kidney Diseases - blood - epidemiology - physiopathology
Kidney Failure, Chronic - blood - epidemiology - physiopathology
Male
Middle Aged
Patient Selection
Patients' Rooms
Primary Health Care
Sweden - epidemiology
Abstract
OBJECTIVE: Estimation of the glomerular filtration rate (GFR) is essential for the evaluation of patients with kidney disease, and for correct dosage of drugs that are eliminated from the circulation by the kidneys. In most cases GFR is estimated based on serum creatinine and the Modification of Diet in Renal Disease (MDRD) formula. As both cystatin C and creatinine are used for the determination of GFR it is important to investigate if estimated GFR by the two methods differ in various patient groups. DESIGN AND METHODS: We have compared cystatin C and MDRD estimated GFR calculated from the same request from primary care units (n=488), a cardiology ward (n=826), the cardiointensive care unit (n=1026), two oncology wards (n=919 and 1021), and the neurosurgical intensive care unit (n=1515) in an observational cross-sectional study. RESULTS: We found better agreement between the two GFR estimates in samples from primary care patients and patients in the cardiology wards, than in samples from oncology wards or the neurosurgical intensive care unit. In the latter settings there was a pronounced difference between the two GFR estimates. CONCLUSION: The comparisons show that differences in patient selections have a strong impact on the agreement between cystatin C and MDRD estimated glomerular filtration rate.
PubMed ID
18674527 View in PubMed
Less detail

17 records – page 1 of 2.