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Your search keyword '"Björn Runesson"' showing total 2 results
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1. Causes of death across categories of estimated glomerular filtration rate: The Stockholm CREAtinine Measurements (SCREAM) project.

Author

Björn Runesson, Abdul R Qureshi, Hong Xu, Alessandro Gasparini, Bengt Lindholm, Peter Barany, Carl G Elinder, and Juan J Carrero

Subjects
Medicine, Science
Abstract

IntroductionReduced kidney function increases the risk of death, but there is limited information on causes of death across stages of chronic kidney disease (CKD). We aimed to identify leading causes of death in community-dwelling individuals with differing kidney function.MethodsObservational analysis from SCREAM, a healthcare utilization cohort of Stockholm, Sweden. We included all individuals who died during 2006-2012 and had one serum creatinine measured in the year prior to death. Using the CKD-EPI formula, we calculated eGFR and stratified individuals according to CKD stages. Causes of death were classified as cardiovascular (CVD), cancer, infection and other, using ICD-10 codes. We compared age- and sex-adjusted differences in the proportions of deaths from each cause.ResultsOut of 89,117 registered deaths, 70,547 (79%) had a recent eGFR estimation and were included in this study. Individuals had a median age of 82 (IRE 62-93) years and 52% were women. The proportions of deaths from CVD increased with lower eGFR, along with the proportion of deaths from infections. Deaths due to diabetes and genito-urinary diseases increased. Deaths due to cancer decreased, but other death causes did not vary. Within CVD causes of death, the proportion of arrhythmias and heart failure increased, but ischemic heart disease and cerebrovascular disease remained stable.ConclusionIn a region-representative Swedish healthcare extraction, we observe differences regarding specific causes of death across different CKD stages. Increasing patient and provider awareness of this differential pattern of risk may have benefits for patient management, prevention strategies, and health service planning.

Published
2019
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2. Incidence of Fractures Before and After Dialysis Initiation

Author

Li Felländer-Tsai, Abdul Rashid Qureshi, Marie Evans, Juan Jesus Carrero, Peter Stenvinkel, Björn Runesson, Hans E. Berg, Bengt Lindholm, and Ken Iseri

Subjects
Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Dialysis patients, 03 medical and health sciences, 0302 clinical medicine, Forearm, Renal Dialysis, Risk Factors, DIALYSIS, medicine, Humans, Orthopedics and Sports Medicine, Statistical analysis, Humerus, Renal osteodystrophy, Dialysis, Retrospective Studies, Sweden, Hip Fractures, business.industry, Incidence, Incidence (epidemiology), Female sex, Original Articles, END‐STAGE KIDNEY DISEASE, medicine.disease, FRACTURE, 030104 developmental biology, medicine.anatomical_structure, Female, Original Article, RENAL OSTEODYSTROPHY, business
Abstract

Fractures are common in dialysis patients, but little is known about the trajectory of incidence rates of different types of fractures before and after dialysis initiation. To address this, we investigated the incidence of major fractures before and after dialysis initiation. We performed a retrospective statistical analysis using the Swedish Renal Registry of 9041 incident dialysis patients (median age 67 years, 67% men) starting dialysis 2005 through 2015 to identify major fractures (hip, spine, humerus, and forearm) occurring during the dialysis transition period from 1 year before until 1 year after dialysis initiation. Using flexible parametric hazard models and the Fine‐Gray model, we estimated adjusted fracture incidence rates and predictors of major fractures. We identified 361 cases with primary diagnosis of major fracture, of which 196 (54%) were hip fractures. The crude incidence rate of major fractures before dialysis initiation was 17 per 1000 patient‐years (n = 157) and after dialysis initiation it was 24 per 1000 patient‐years (n = 204). The adjusted incidence rate of major fractures began to increase 6 months before dialysis initiation, and then stabilized at a higher rate after 1 year. The adjusted incidence rate of hip fractures started to increase sharply 3 months before dialysis initiation, peaked at initiation, and declined thereafter. In contrast, the adjusted incidence rate of non‐hip fractures was stable during the transition period and gradually increased over time. Higher age, female sex, and history of previous major fractures were associated with increased fracture incidence both before and after dialysis initiation. We conclude that the incidence of major fractures, especially hip fractures, start to rise 6 months before initiation of dialysis therapy, indicating that heightened surveillance with implementation of preventive measures to avoid fractures is warranted during the transition period to dialysis. © 2020 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Published
2020
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