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1. Quenching Factor estimation of Na recoils in NaI(Tl) crystals using a low-energy pulsed neutron beam measurement

Author

Mukund Raghunath Bharadwaj, G. Angloher, P. S. Barbeau, I. Dafinei, N. Di Marco, L. Einfalt, F. Ferroni, S. Fichtinger, A. Filipponi , T. Frank , M. Friedl , A. Fuss, Z. Ge , S. Hedges, M. Heikinheimo, K. Huitu, M. Kellermann, R. Maji, M. Mancuso, L. Pagnanini, F. Petricca, S. Pirro, F. Pröbst , G. Profeta, A. Puiu, F. Reindl , K. Schäffner, J. Schieck, D. Schmiedmayer , C. Schwertner , M. Stahlberg , A. Stendahl, M. Stukel , F. Wagner, S. Yue, V. Zema, Y. Zhu

Subjects
Physics, QC1-999
Abstract

NaI(Tl) based scintillation detectors have become a staple in the field of direct dark matter searches, with the DAMA-LIBRA experiment being the standout for its reported observation of an annually modulating WIMP-like signal which is in direct contrast with other results. In order to accurately calibrate the energies of WIMP-induced nuclear recoil signals, precise measurements of the quenching factor of the NaI crystals are essential for each of these experiments, as it is well established that electron recoils and nuclear recoils have dissimilar scintillation light yields. In this contribution, we present first preliminary results of an ongoing systematic study that has been carried out by the COSINUS collaboration and Duke University to measure the quenching factor of Na recoils. Five ultra-pure NaI crystals, manufactured by the Shanghai Institute for Ceramics, each of which have varying Tl dopant concentrations, were irradiated with a mono-energetic neutron beam at the Triangle Universities National Laboratory, North Carolina, USA to extract the quenching factor values in the low recoil energies of 1-30keV$_{nr}$.

Published
2023
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2. remoTES: A new design for the cryogenic NaI detectors of the COSINUS experiment

Author

L. Einfalt, G. Angloher, Mukund Raghunath Bharadwaj, I. Dafinei, N. Di Marco, F. Ferroni, S. Fichtinger, A. Filipponi, T. Frank, M. Friedl, A. Fuss, Z. Ge, M. Heikinheimo, K. Huitu, M. Kellermann, R. Maji , M. Mancuso, L. Pagnanini, F. Petricca, S. Pirro, F. Pröbst, G. Profeta, A. Puiu, F. Reindl, K. Schäffner, J. Schieck, D. Schmiedmayer, C. Schwertner, M. Stahlberg, A. Stendahl, M. Stukel , F. Wagner, S. Yue, V. Zema, Y. Zhu

Subjects
Physics, QC1-999
Abstract

The increasing statistical significance of the DAMA/LIBRA annual modulation signal is a cause for tension in the field of dark matter direct detection. The COSINUS experiment aims at a model-independent cross-check of the DAMA/LIBRA signal claim, using NaI crystals operated as cryogenic scintillating calorimeters at millikelvin temperatures. Such a setup enables measurement of phonon and scintillation light signals via Transition Edge Sensors (TESs) and allows particle discrimination on an event-by-event basis. The non-standard properties of NaI cause an obstacle when attaching a TES directly onto the surface of the crystal. This can be overcome with the ``remoTES'' design, where the TES is attached to an external wafer crystal. We present the results from a first successful operation of NaI and other crystals as cryogenic calorimeters with the remoTES design.

Published
2023
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4. The relationship between uremic toxins and symptoms in older men and women with advanced chronic kidney disease

Author

Massy Z. A., Chesnaye N. C., Larabi I. A., Dekker F. W., Evans M., Caskey F. J., Torino C., Porto G., Szymczak M., Drechsler C., Wanner C., Jager K. J., Alvarez J. C., Schneider A., Torp A., Iwig B., Perras B., Marx C., Blaser C., Emde C., Krieter D., Fuchs D., Irmler E., Platen E., Schmidt-Gurtler H., Schlee H., Naujoks H., Schlee I., Casar S., Beige J., Rothele J., Mazur J., Hahn K., Blouin K., Neumeier K., Anding-Rost K., Schramm L., Hopf M., Wuttke N., Frischmuth N., Ichtiaris P., Kirste P., Schulz P., Aign S., Biribauer S., Manan S., Roser S., Heidenreich S., Palm S., Schwedler S., Delrieux S., Renker S., Schattel S., Stephan T., Schmiedeke T., Weinreich T., Leimbach T., Stovesand T., Bahner U., Seeger W., Cupisti A., Sagliocca A., Ferraro A., Mele A., Naticchia A., Cosaro A., Ranghino A., Stucchi A., Pignataro A., De Blasio A., Pani A., Tsalouichos A., Bellasi A., Raffaele Di Iorio B., Butti A., Abaterusso C., Somma C., D'Alessandro C., Zullo C., Pozzi C., Bergamo D., Ciurlino D., Motta D., Russo D., Favaro E., Vigotti F., Ansali F., Conte F., Cianciotta F., Giacchino F., Cappellaio F., Pizzarelli F., Greco G., Bigatti G., Marinangeli G., Cabiddu G., Fumagalli G., Caloro G., Piccoli G., Capasso G., Gambaro G., Tognarelli G., Bonforte G., Conte G., Toscano G., Del Rosso G., Capizzi I., Baragetti I., Oldrizzi L., Gesualdo L., Biancone L., Magnano M., Ricardi M., Di Bari M., Laudato M., Luisa Sirico M., Ferraresi M., Provenzano M., Malaguti M., Palmieri N., Murrone P., Cirillo P., Dattolo P., Acampora P., Nigro R., Boero R., Scarpioni R., Sicoli R., Malandra R., Savoldi S., Bertoli S., Borrelli S., Maxia S., Maffei S., Mangano S., Cicchetti T., Rappa T., Palazzo V., De Simone W., Schrander A., Van Dam B., Siegert C., Gaillard C., Beerenhout C., Verburgh C., Janmaat C., Hoogeveen E., Hoorn E., Boots J., Boom H., Eijgenraam J. -W., Kooman J., Rotmans J., Vogt L., Raasveld M., Vervloet M., Van Buren M., Van Diepen M., Leurs P., Voskamp P., Blankestijn P., Van Esch S., Boorsma S., Berger S., Konings C., Aydin Z., Musiala A., Szymczak A., Olczyk E., Augustyniak-Bartosik H., Miskowiec-Wisniewska I., Manitius J., Pondel J., Jedrzejak K., Nowanska K., Nowak L., Durlik M., Dorota S., Nieszporek T., Heleniak Z., Jonsson A., Blom A. -L., Rogland B., Wallquist C., Vargas D., Dimeny E., Sundelin F., Uhlin F., Welander G., Bascaran Hernandez I., Grontoft K. -C., Stendahl M., Svensson M., Heimburger O., Kashioulis P., Melander S., Almquist T., Jensen U., Woodman A., McKeever A., Ullah A., McLaren B., Harron C., Barrett C., O'Toole C., Summersgill C., Geddes C., Glowski D., McGlynn D., Sands D., Roy G., Hirst G., King H., McNally H., Masri-Senghor H., Murtagh H., Rayner H., Turner J., Wilcox J., Berdeprado J., Wong J., Banda J., Jones K., Haydock L., Wilkinson L., Carmody M., Weetman M., Joinson M., Dutton M., Matthews M., Morgan N., Bleakley N., Cockwell P., Roderick P., Mason P., Kalra P., Sajith R., Chapman S., Navjee S., Crosbie S., Brown S., Tickle S., Mathavakkannan S., Kuan Y., Massy, Z. A., Chesnaye, N. C., Larabi, I. A., Dekker, F. W., Evans, M., Caskey, F. J., Torino, C., Porto, G., Szymczak, M., Drechsler, C., Wanner, C., Jager, K. J., Alvarez, J. C., Schneider, A., Torp, A., Iwig, B., Perras, B., Marx, C., Blaser, C., Emde, C., Krieter, D., Fuchs, D., Irmler, E., Platen, E., Schmidt-Gurtler, H., Schlee, H., Naujoks, H., Schlee, I., Casar, S., Beige, J., Rothele, J., Mazur, J., Hahn, K., Blouin, K., Neumeier, K., Anding-Rost, K., Schramm, L., Hopf, M., Wuttke, N., Frischmuth, N., Ichtiaris, P., Kirste, P., Schulz, P., Aign, S., Biribauer, S., Manan, S., Roser, S., Heidenreich, S., Palm, S., Schwedler, S., Delrieux, S., Renker, S., Schattel, S., Stephan, T., Schmiedeke, T., Weinreich, T., Leimbach, T., Stovesand, T., Bahner, U., Seeger, W., Cupisti, A., Sagliocca, A., Ferraro, A., Mele, A., Naticchia, A., Cosaro, A., Ranghino, A., Stucchi, A., Pignataro, A., De Blasio, A., Pani, A., Tsalouichos, A., Bellasi, A., Raffaele Di Iorio, B., Butti, A., Abaterusso, C., Somma, C., D'Alessandro, C., Zullo, C., Pozzi, C., Bergamo, D., Ciurlino, D., Motta, D., Russo, D., Favaro, E., Vigotti, F., Ansali, F., Conte, F., Cianciotta, F., Giacchino, F., Cappellaio, F., Pizzarelli, F., Greco, G., Bigatti, G., Marinangeli, G., Cabiddu, G., Fumagalli, G., Caloro, G., Piccoli, G., Capasso, G., Gambaro, G., Tognarelli, G., Bonforte, G., Conte, G., Toscano, G., Del Rosso, G., Capizzi, I., Baragetti, I., Oldrizzi, L., Gesualdo, L., Biancone, L., Magnano, M., Ricardi, M., Di Bari, M., Laudato, M., Luisa Sirico, M., Ferraresi, M., Provenzano, M., Malaguti, M., Palmieri, N., Murrone, P., Cirillo, P., Dattolo, P., Acampora, P., Nigro, R., Boero, R., Scarpioni, R., Sicoli, R., Malandra, R., Savoldi, S., Bertoli, S., Borrelli, S., Maxia, S., Maffei, S., Mangano, S., Cicchetti, T., Rappa, T., Palazzo, V., De Simone, W., Schrander, A., Van Dam, B., Siegert, C., Gaillard, C., Beerenhout, C., Verburgh, C., Janmaat, C., Hoogeveen, E., Hoorn, E., Boots, J., Boom, H., Eijgenraam, J. -W., Kooman, J., Rotmans, J., Vogt, L., Raasveld, M., Vervloet, M., Van Buren, M., Van Diepen, M., Leurs, P., Voskamp, P., Blankestijn, P., Van Esch, S., Boorsma, S., Berger, S., Konings, C., Aydin, Z., Musiala, A., Szymczak, A., Olczyk, E., Augustyniak-Bartosik, H., Miskowiec-Wisniewska, I., Manitius, J., Pondel, J., Jedrzejak, K., Nowanska, K., Nowak, L., Durlik, M., Dorota, S., Nieszporek, T., Heleniak, Z., Jonsson, A., Blom, A. -L., Rogland, B., Wallquist, C., Vargas, D., Dimeny, E., Sundelin, F., Uhlin, F., Welander, G., Bascaran Hernandez, I., Grontoft, K. -C., Stendahl, M., Svensson, M., Heimburger, O., Kashioulis, P., Melander, S., Almquist, T., Jensen, U., Woodman, A., Mckeever, A., Ullah, A., Mclaren, B., Harron, C., Barrett, C., O'Toole, C., Summersgill, C., Geddes, C., Glowski, D., Mcglynn, D., Sands, D., Roy, G., Hirst, G., King, H., Mcnally, H., Masri-Senghor, H., Murtagh, H., Rayner, H., Turner, J., Wilcox, J., Berdeprado, J., Wong, J., Banda, J., Jones, K., Haydock, L., Wilkinson, L., Carmody, M., Weetman, M., Joinson, M., Dutton, M., Matthews, M., Morgan, N., Bleakley, N., Cockwell, P., Roderick, P., Mason, P., Kalra, P., Sajith, R., Chapman, S., Navjee, S., Crosbie, S., Brown, S., Tickle, S., Mathavakkannan, S., Kuan, Y., Nephrology, ACS - Diabetes & metabolism, Medical Informatics, APH - Methodology, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, APH - Health Behaviors & Chronic Diseases, and ACS - Pulmonary hypertension & thrombosis

Subjects
Transplantation, Nephrology, uremic toxins, CKD, symptoms, symptom, elderly
Abstract

Background Patients with stage 4/5 chronic kidney disease (CKD) suffer from various symptoms. The retention of uremic solutes is thought to be associated with those symptoms. However, there are relatively few rigorous studies on the potential links between uremic toxins and symptoms in patients with CKD. Methods The EQUAL study is an ongoing observational cohort study of non-dialyzed patients with stage 4/5 CKD. EQUAL patients from Germany, Poland, Sweden and the UK were included in the present study (n = 795). Data and symptom self-report questionnaires were collected between April 2012 and September 2020. Baseline uric acid and parathyroid hormone and 10 uremic toxins were quantified. We tested the association between uremic toxins and symptoms and adjusted P-values for multiple testing. Results Symptoms were more frequent in women than in men with stage 4/5 CKD, while levels of various uremic toxins were higher in men. Only trimethylamine N-oxide (TMAO; positive association with fatigue), p-cresyl sulfate (PCS) with constipation and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid (negative association with shortness of breath) demonstrated moderately strong associations with symptoms in adjusted analyses. The association of phenylacetylglutamine with shortness of breath was consistent in both sexes, although it only reached statistical significance in the full population. In contrast, TMAO (fatigue) and PCS and phenylacetylglutamine (constipation) were only associated with symptoms in men, who presented higher serum levels than women. Conclusion Only a limited number of toxins were associated with symptoms in persons with stage 4/5 CKD. Other uremic toxins, uremia-related factors or psychosocial factors not yet explored might contribute to symptom burden.

Published
2022

5. Kidney Versus Combined Kidney and Liver Transplantation in Young People With Autosomal Recessive Polycystic Kidney Disease: Data From the European Society for Pediatric Nephrology/European Renal Association−European Dialysis and Transplant (ESPN/ERA-EDTA) Registry

Author

Levtchenko, E., Haffner, D., Bjerre, A., Massy, Z., Shtiza, D., Kramar, R., Oberbauer, R., Baiko, S., Sukalo, A., van Hoeck, K., Collart, F., des Grottes, J.M., Pokrajac, D., Roussinov, D., Batinić, D., Lemac, M., Slavicek, J., Seeman, T., Vondrak, K., Heaf, J.G., Toots, U., Finne, P., Grönhagen-Riska, C., Couchoud, C., Lasalle, M, Sahpazova, E, Abazi, N, Ristoka Bojkovska, N, von Gersdorff, G, Scholz, C, Tönshoff, B, Krupka, K, Höcker, B, Pape, L, Afentakis, N, Kapogiannis, A, Printza, N, Reusz, G, Berecki, Cs, Szabó, A, Szabó, T, Györke, Z.S., Kis, E., Palsson, R., Edvardsson, V., Gianoglio, B., Maringhini, S., Pecoraro, C., Picca, S., Testa, S., Vidal, E., Verrina, E., Jankauskiene, A., Pundziene, B., Said-Conti, V., Gatcan, S., Berbeca, O., Zaikova, N., Pavićević, S., Leivestad, T., Zurowska, A., Zagozdzon, I., Mota, C., Almeida, M., Afonso, C., Mircescu, G., Garneata, L., Molchanova, E.A., Tomilina, N.A., Bikbov, B.T., Kostic, M., Peco-Antic, A., Spasojevic-Dimitrijeva, B., Milosevski-Lomic, G., Paripovic, D., Puric, S., Kruscic, D., Podracka, L., Kolvek, G., Buturovic-Ponikvar, J., Novljan, G., Battelino, N., Alonso Melgar, A., Schön, S., Prütz, K.G., Backmän, L., Stendahl, M., Evans, M., Rippe, B., Kuenhi, C.E., Maurer, E., Laube, G.F., Tschumi, S., Parvex, P., Hoitsma, A., Hemke, A., Topaloglu, R., Duzova, A., Ivanov, D., Pruthi, R., Braddon, F., Mannings, S., Cassula, A., Sinha, M.D., Mekahli, Djalila, van Stralen, Karlijn J., Bonthuis, Marjolein, Jager, Kitty J., Balat, Ayşe, Benetti, Elisa, Godefroid, Nathalie, Edvardsson, Vidar O., Heaf, James G., Jankauskiene, Augustina, Kerecuk, Larissa, Marinova, Svetlana, Puteo, Flora, Seeman, Tomas, Zurowska, Aleksandra, Pirenne, Jacques, Schaefer, Franz, and Groothoff, Jaap W.

Published
2016
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6. Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Author

Hemmelder, M. H., Noordzij, M., Vart, P., Hilbrands, L. B., Jager, K. J., Abrahams, A. C., Arroyo, D., Battaglia, Y., Ekart, R., Mallamaci, F., Malloney, S. -R., Oliveira, J., Rydzewski, A., Sridharan, S., Vogt, L., Duivenvoorden, R., Gansevoort, R. T., Franssen, C. F. M., van der Net, J. B., Essig, M., du Buf-Vereijken, P. W. G., van Ginneken, B., Maas, N., van Jaarsveld, B. C., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Konings, C. J. A. M., Braconnier, P., Weis, D., Gellert, R., Alferes, D. G., Radulescu, D., Zakharova, E. V., Ambuehl, P. M., Guidotti, R., Walker, A., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Majstorovic, G. S., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Liakopoulos, V., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Kuryata, O., Slebe, J. J. P., Abd ElHafeez, S., Kemlin, D., van de Wetering, J., Reinders, M. E. J., Hesselink, D. A., van Gestel, J. K., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Logan, I., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Polyzou Konsta, M. A., Panagoutsos, S., Postorino, A., Cambareri, F., Matceac, I., Nistor, I., Covic, A., Groeneveld, J. H. M., Jousma, J., Diekmann, F., Oppenheimer, F., Blasco, M., Pereira, T. A., dos Santos Junior, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Arenas Jimenez, M. D., Mendoza-Valderrey, A., Martins, A. C., Mateus, C., Alvila, G., Laranjinha, I., Hofstra, J. M., Siezenga, M. A., Franco, A., Castellano, S., Rodriguez-Ferrero, M. L., Manzanos, S. B., Haridian Sosa Barrios, R., Lemahieu, W., Bartelet, K., Dirim, A. B., Demir, E., Sever, M. S., Turkmen, A., Safak, S., Hollander, D. A. M. J., Kerckhoffs, A., Buttner, S., de Vries, A. P. J., Meziyerh, S., van der Helm, D., Mallat, M., Bouwsma, H., Petruliene, K., Verberk, I., van der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Luca, M. D., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Gandolfini, I., Maggiore, U., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., de Fijter, C. W. H., Mongera, N., Pini, S., de Biase, C., van de Logt, A. E., Maas, R., Lebedeva, O., Lopez, V., Reichert, L. J. M., Verhave, J., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., van Kempen, G., van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Lentini, P., den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Sahin, I., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Coca, A., de Arriba, G., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnerlier, A., Wissing, K. M., Dedinska, I., Pessolano, G., Malik, S., Dounousi, E., Papachristou, E., Berger, S. P., Meijer, E., Sanders, J. S. F., Ozyilmaz, A., Ponikvar, J. B., Pernat, A. M., Kovac, D., Arnol, M., Molenaar, F. M., van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Gallieni, M., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Heitink-Ter Braak, N., Nephrology, ACS - Microcirculation, ACS - Diabetes & metabolism, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Clinical sciences, Faculteit Medische Wetenschappen/UMCG, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, APH - Health Behaviors & Chronic Diseases, and Internal Medicine

Subjects
Male, Outcome Assessment, survival, mental health status, COVID-19 Testing, SDG 3 - Good Health and Well-being, Renal Dialysis, functional health status, Outcome Assessment, Health Care, 80 and over, Humans, KIDNEY-TRANSPLANT, AcademicSubjects/MED00340, Aged, Aged, 80 and over, Transplantation, SARS-CoV-2, MORTALITY, COVID-19, Middle Aged, Health Care, Intensive Care Units, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, dialysis, Original Article, Female, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
Abstract

Background Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8–6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.

Published
2022

8. Clinical triage of patients on kidney replacement therapy presenting with COVID-19: An ERACODA registry analysis

Author

Mitra, S., Jayanti, A., Vart, P., Coca, A., Gallieni, M., Ovrehus, M. A., Midtvedt, K., Abd Elhafeez, S., Gandolfini, I., Buttner, S., Franssen, C. F. M., Hemmelder, M. H., Van Der Net, J. B., Essig, M., Du Buf-Vereijken, P. W. G., Van Ginneken, B., Maas, N., Vogt, L., Van Jaarsveld, B. C., Jager, K. J., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Rydzewski, A., Gellert, R., Oliveira, J., Alferes, D. G., Zakharova, E. V., Ambuehl, P. M., Walker, A., Winzeler, R., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Slebe, J. J. P., Kemlin, D., Van De Wetering, J., Reinders, M. E. J., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Konsta, M. A. P., Panagoutsos, S., Mallamaci, F., Postorino, A., Cambareri, F., Covic, A., Matceac, I., Nistor, I., Cordos, M., Groeneveld, J. H. M., Jousma, J., Marjolijn Van Buren, Diekmann, F., Tiago Assis Pereira, Santos, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Jimenez, M. D. A., Hofstra, J. M., Franco, A., Arroyo, D., Rodriguez-Ferrero, M. L., Manzanos, S. B., Barrios, R. H. S., Avila, G., Laranjinha, I., Mateus, C., Lemahieu, W., Bartelet, K., Dirim, A. B., Sever, M. S., Demir, E., Safak, S., Turkmen, A., Hollander, D. A. M. J., De Vries, A. P. J., Meziyerh, S., Van Der Helm, D., Mallat, M., Bouwsma, H., Sridharan, S., Petruliene, K., Maloney, S. -R., Verberk, I., Van Der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Di Luca, M., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., De Fijter, C. W. H., Mongera, N., Pini, S., De Biase, C., Duivenvoorden, R., Hilbrands, L., Kerckhoffs, A., Van De Logt, A. -E., Maas, R., Lebedeva, O., Lopez, V., Verhave, J., Reichert, L. J. M., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., Van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Battaglia, Y., Lentini, P., Den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnelier, A., Wissing, K. M., De Arriba, G., Dedinska, I., Pessolano, G., Maggiore, U., Malik, S., Papachristou, E., Gansevoort, R. T., Noordzij, M., Berger, S. P., Meijer, E., Ozyilmaz, A., Sanders, J. S. F., Ponikvar, J. B., Arnol, M., Pernat, A. M., Kovac, D., Ekart, R., Abrahams, A. C., Molenaar, F. M., Van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Sabiu, G., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., Van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Braak, N. H. -T., Nephrology, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Groningen Kidney Center (GKC), ACS - Diabetes & metabolism, AII - Inflammatory diseases, AII - Infectious diseases, Internal Medicine, and Clinical sciences

Subjects
kidney, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Pulmonary insufficiency, infectious diseases, Kidney, Second presentation, Interquartile range, Internal medicine, medicine, Humans, Registries, Mortality, AcademicSubjects/MED00340, Dialysis, Aged, Transplantation, second presentation, business.industry, SARS-CoV-2, COVID-19, medicine.disease, mortality, Triage, Hospitalization, Renal Replacement Therapy, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, Oxygen Saturation, dialysis, Original Article, Hemodialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], Presentation (obstetrics), business, transplantation
Abstract

Background Patients on kidney replacement therapy (KRT) are at very high risk of coronavirus disease 2019 (COVID-19). The triage pathway for KRT patients presenting to hospitals with varying severity of COVID-19 illness remains ill-defined. We studied the clinical characteristics of patients at initial and subsequent hospital presentations and the impact on patient outcomes. Methods The European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized at initial triage and those re-presenting a second time. Predictors of outcomes (hospitalization, 28-day mortality) were then determined for all those not hospitalized at initial triage. Results Among 1423 KRT patients with COVID-19 [haemodialysis (HD), n = 1017; transplant, n = 406), 25% (n = 355) were not hospitalized at first presentation due to mild illness (30% HD, 13% transplant). Of the non-hospitalized patients, only 10% (n = 36) re-presented a second time, with a 5-day median interval between the two presentations (interquartile range 2–7 days). Patients who re-presented had worsening respiratory symptoms, a decrease in oxygen saturation (97% versus 90%) and an increase in C-reactive protein (26 versus 73 mg/L) and were older (72 vs 63 years) compared with those who did not return a second time. The 28-day mortality between early admission (at first presentation) and deferred admission (at second presentation) was not significantly different (29% versus 25%; P = 0.6). Older age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation were identified as risk predictors of mortality when re-presenting after discharge at initial triage. Conclusions This study provides evidence that KRT patients with COVID-19 and mild illness can be managed effectively with supported outpatient care and with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19 to aid clinical triage and optimize resource utilization during the ongoing pandemic.

Published
2021

9. Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data

Author

Matsushita, K, Ballew, Sh, Coresh, J, Arima, H, Ärnlöv, J, Cirillo, Massimo, Ebert, N, Hiramoto, Js, Kimm, H, Shlipak, Mg, Visseren, Flj, Gansevoort, Rt, Kovesdy, Cp, Shalev, V, Woodward, M, Kronenberg, F, Chronic Kidney Disease Prognosis Consortium: Chalmers, J, Perkovic, V, Grams, Me, Sang, Y, Schaeffner, E, Martus, P, Levin, A, Djurdjev, O, Tang, M, Heine, G, Seiler, S, Zawada, A, Emrich, I, Sarnak, M, Katz, R, Brenner, H, Schöttker, B, Rothenbacher, D, Saum, Ku, Köttgen, A, Schneider, M, Eckardt, Ku, Green, J, Kirchner, Hl, Chang, Ar, Black, C, Marks, A, Prescott, G, Clark, L, Fluck, N, Jee, Sh, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Bots, M, Peralta, C, Hiromoto, J, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Kenealy, T, Elley, Cr, Collins, Jf, Drury, Pl, Bakker, Sj, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Jh, Ix, Barrett Connor, E, Kalantar Zadeh, K, Carrero, Jj, Gasparini, A, Qureshi, Ar, Barany, P, Algra, A, Van, Der, Graaf, Y, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Lannfelt, L, Larsson, A, Hallan, S, Levey, As, Chen, J, Kwak, L, Sang, Y., Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Matsushita, K, Ballew, Sh, Coresh, J, Arima, H, Ärnlöv, J, Cirillo, Massimo, Ebert, N, Hiramoto, J, Kimm, H, Shlipak, Mg, Visseren, Flj, Gansevoort, Rt, Kovesdy, Cp, Shalev, V, Woodward, M, Kronenberg, F, Chronic Kidney Disease Prognosis Consortium: Chalmers, J, Perkovic, V, Grams, Me, Sang, Y, Schaeffner, E, Martus, P, Levin, A, Djurdjev, O, Tang, M, Heine, G, Seiler, S, Zawada, A, Emrich, I, Sarnak, M, Katz, R, Brenner, H, Schöttker, B, Rothenbacher, D, Saum, Ku, Köttgen, A, Schneider, M, Eckardt, Ku, Green, J, Kirchner, Hl, Chang, Ar, Black, C, Marks, A, Prescott, G, Clark, L, Fluck, N, Jee, Sh, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Ad, Bots, M, Peralta, C, Hiromoto, J, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Kenealy, T, Elley, Cr, Collins, Jf, Drury, Pl, Bakker, Sj, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett Connor, E, Kalantar Zadeh, K, Carrero, Jj, Gasparini, A, Qureshi, Ar, Barany, P, Algra, A, Van, Der, Graaf, Y, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Lannfelt, L, Larsson, A, Hallan, S, Levey, A, Chen, J, Kwak, L, and Sang, Y.

Subjects
Male, Databases, Factual, Endocrinology, Diabetes and Metabolism, nefropatia, arteriopatia periferica, epidemiologia, 030204 cardiovascular system & hematology, GLOMERULAR-FILTRATION-RATE, arteriopatia periferica, 0302 clinical medicine, Endocrinology, Risk Factors, CRITICAL LIMB ISCHEMIA, 030212 general & internal medicine, epidemiologia, POPULATION, biology, CYSTATIN C, Incidence, Middle Aged, PREVALENCE, Diabetes and Metabolism, nefropatia, Creatinine, Female, medicine.symptom, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Renal function, ATHEROSCLEROSIS RISK, HEART-ASSOCIATION, CARDIOVASCULAR OUTCOMES, 03 medical and health sciences, Peripheral Arterial Disease, Internal medicine, Diabetes mellitus, medicine, Internal Medicine, Albuminuria, Humans, Risk factor, Renal Insufficiency, Chronic, Aged, business.industry, Critical limb ischemia, medicine.disease, Intermittent claudication, Surgery, Cystatin C, biology.protein, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Kidney disease
Abstract

BACKGROUND: Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease.METHODS: In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation). We assessed discrimination improvement through c-statistics.FINDINGS: We analysed 817 084 individuals without a history of peripheral artery disease at baseline from 21 cohorts. 18 261 cases of peripheral artery disease were recorded during follow-up across cohorts (median follow-up was 7·4 years [IQR 5·7-8·9], range 2·0-15·8 years across cohorts). Both chronic kidney disease measures were independently associated with the incidence of peripheral artery disease. Compared with an eGFR of 95 mL/min per 1·73 m(2), adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14-1·30) at an eGFR of 45 mL/min per 1·73 m(2) and 2·06 (1·70-2·48) at an eGFR of 15 mL/min per 1·73 m(2). Compared with an ACR of 5 mg/g, the adjusted HR for incident study-specific peripheral artery disease was 1·50 (1·41-1·59) at an ACR of 30 mg/g and 2·28 (2·12-2·44) at an ACR of 300 mg/g. The adjusted HR at an ACR of 300 mg/g versus 5 mg/g was 3·68 (95% CI 3·00-4·52) for leg amputation. eGFR and albuminuria contributed multiplicatively (eg, adjusted HR 5·76 [4·90-6·77] for incident peripheral artery disease and 10·61 [5·70-19·77] for amputation in eGFR INTERPRETATION: Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation. Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.FUNDING: American Heart Association, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.

Published
2017

10. Adiposity and risk of decline in glomerular filtration rate : Meta-analysis of individual participant data in a global consortium

Author

Chang AR, Grams ME, Ballew SH, Bilo H, Correa A, Evans M, Gutierrez OM, Hosseinpanah F, Iseki K, Kenealy T, Klein B, Kronenberg F, Lee BJ, Li Y, Miura K, Navaneethan SD, Roderick PJ, Valdivielso JM, Visseren FLJ, Zhang L, Gansevoort RT, Hallan SI, Levey AS, Matsushita K, Shalev V, Woodward M, Astor B, Appel L, Greene T, Chen T, Chalmers J, Arima H, Perkovic V, Yatsuya H, Tamakoshi K, Hirakawa Y, Coresh J, Sang Y, Polkinghorne K, Chadban S, Atkins R, Levin A, Djurdjev O, Klein R, Lee K, Liu L, Zhao M, Wang F, Wang J, Tang M, Heine G, Emrich I, Zawada A, Bauer L, Nally J, Schold J, Shlipak M, Sarnak M, Katz R, Hiramoto J, Iso H, Yamagishi K, Umesawa M, Muraki I, Fukagawa M, Maruyama S, Hamano T, Hasegawa T, Fujii N, Jafar T, Hatcher J, Poulter N, Chaturvedi N, Wheeler D, Emberson J, Townend J, Landray M, Brenner H, Schöttker B, Saum KU, Rothenbacher D, Fox C, Hwang SJ, Köttgen A, Schneider MP, Eckardt KU, Green J, Kirchner HL, Ito S, Miyazaki M, Nakayama M, Yamada G, Cirillo M, Romundstad S, Øvrehus M, Langlo KA, Irie F, Sairenchi T, Rebholz CM, Young B, Boulware LE, Ishikawa S, Yano Y, Kotani K, Nakamura T, Jee SH, Kimm H, Mok Y, Chodick G, Wetzels JFM, Blankestijn PJ, van Zuilen AD, Bots M, Inker L, Peralta C, Kollerits B, Ritz E, Nitsch D, Fletcher A, Bottinger E, Nadkarni GN, Ellis SB, Nadukuru R, Fernandez E, Betriu A, Bermudez-Lopez M, Stengel B, Metzger M, Flamant M, Houillier P, Haymann JP, Froissart M, Ueshima H, Okayama A, Tanaka S, Okamura T, Elley CR, Collins JF, Drury PL, Ohkubo T, Asayama K, Metoki H, Kikuya M, Iseki C, Nelson RG, Knowler WC, Bakker SJL, Heerspink HJL, Brunskill N, Major R, Shepherd D, Medcalf J, Jassal SK, Bergstrom J, Ix JH, Barrett-Connor E, Kovesdy C, Kalantar-Zadeh K, Sumida K, Muntner P, Warnock D, Judd S, Panwar B, de Zeeuw D, Brenner B, Sedaghat S, Ikram MA, Hoorn EJ, Dehghan A, Wong TY, Sabanayagam C, Cheng CY, Banu R, Segelmark M, Stendahl M, Schön S, Tangri N, Sud M, Naimark D, Wen CP, Tsao CK, Tsai MK, Chen CH, Konta T, Hirayama A, Ichikawa K, Hadaegh F, Mirbolouk M, Azizi F, Solbu MD, Jenssen TG, Eriksen BO, Eggen AE, Lannfelt L, Larsson A, Ärnlöv J, Landman GWD, van Hateren KJJ, Kleefstra N, Chen J, Kwak L, Surapaneni A., Chang, Ar, Grams, Me, Ballew, Sh, Bilo, H, Correa, A, Evans, M, Gutierrez, Om, Hosseinpanah F, Iseki K, Kenealy, T, Klein, B, Kronenberg, F, Lee, Bj, Li, Y, Miura, K, Navaneethan, Sd, Roderick, Pj, Valdivielso, Jm, Visseren, Flj, Zhang, L, Gansevoort, Rt, Hallan, Si, Levey, A, Matsushita, K, Shalev, V, Woodward, M, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Arima, H, Perkovic, V, Yatsuya, H, Tamakoshi, K, Hirakawa, Y, Coresh, J, Sang, Y, Polkinghorne, K, Chadban, S, Atkins, R, Levin, A, Djurdjev, O, Klein, R, Lee, K, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Heine, G, Emrich, I, Zawada, A, Bauer, L, Nally, J, Schold, J, Shlipak, M, Sarnak, M, Katz, R, Hiramoto, J, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Hasegawa, T, Fujii, N, Jafar, T, Hatcher, J, Poulter, N, Chaturvedi, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Brenner, H, Schöttker, B, Saum, Ku, Rothenbacher, D, Fox, C, Hwang, Sj, Köttgen, A, Schneider, Mp, Eckardt, Ku, Green, J, Kirchner, Hl, Ito, S, Miyazaki, M, Nakayama, M, Yamada, G, Cirillo, M, Romundstad, S, Øvrehus, M, Langlo, Ka, Irie, F, Sairenchi, T, Rebholz, Cm, Young, B, Boulware, Le, Ishikawa, S, Yano, Y, Kotani, K, Nakamura, T, Jee, Sh, Kimm, H, Mok, Y, Chodick, G, Wetzels, Jfm, Blankestijn, Pj, van Zuilen, Ad, Bots, M, Inker, L, Peralta, C, Kollerits, B, Ritz, E, Nitsch, D, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Fernandez, E, Betriu, A, Bermudez-Lopez, M, Stengel, B, Metzger, M, Flamant, M, Houillier, P, Haymann, Jp, Froissart, M, Ueshima, H, Okayama, A, Tanaka, S, Okamura, T, Elley, Cr, Collins, Jf, Drury, Pl, Ohkubo, T, Asayama, K, Metoki, H, Kikuya, M, Iseki, C, Nelson, Rg, Knowler, Wc, Bakker, Sjl, Heerspink, Hjl, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, Sumida, K, Muntner, P, Warnock, D, Judd, S, Panwar, B, de Zeeuw, D, Brenner, B, Sedaghat, S, Ikram, Ma, Hoorn, Ej, Dehghan, A, Wong, Ty, Sabanayagam, C, Cheng, Cy, Banu, R, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Hirayama, A, Ichikawa, K, Hadaegh, F, Mirbolouk, M, Azizi, F, Solbu, Md, Jenssen, Tg, Eriksen, Bo, Eggen, Ae, Lannfelt, L, Larsson, A, Ärnlöv, J, Landman, Gwd, van Hateren, Kjj, Kleefstra, N, Chen, J, Kwak, L, Surapaneni, A., Lifestyle Medicine (LM), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Asayama, Kei, and Sedaghat, SeyyedMah

Subjects
CHRONIC KIDNEY-DISEASE, Male, 030232 urology & nephrology, 030204 cardiovascular system & hematology, OBESITY PARADOX, Body Mass Index, BMI, eGFR, CKD-PC, Cohort Studies, 0302 clinical medicine, Risk Factors, Urologi och njurmedicin, Medicine, ALL-CAUSE MORTALITY, Adiposity, 2. Zero hunger, Aged, 80 and over, Medicine(all), education.field_of_study, Hazard ratio, ASSOCIATION, General Medicine, Middle Aged, 3. Good health, Cohort, Female, Waist Circumference, Life Sciences & Biomedicine, WAIST CIRCUMFERENCE, Obesity paradox, Glomerular Filtration Rate, Adult, Waist, Population, Renal function, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, CKD, Urology and Nephrology, Humans, Mortality, education, Aged, Science & Technology, business.industry, Research, medicine.disease, Body Height, BODY-MASS INDEX, Kidney Failure, Chronic, WEIGHT, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Body mass index, Demography, Kidney disease
Abstract

ObjectiveTo evaluate the associations between adiposity measures (body mass index, waist circumference, and waist-to-height ratio) with decline in glomerular filtration rate (GFR) and with all cause mortality.DesignIndividual participant data meta-analysis.SettingCohorts from 40 countries with data collected between 1970 and 2017.ParticipantsAdults in 39 general population cohorts (n=5 459 014), of which 21 (n=594 496) had data on waist circumference; six cohorts with high cardiovascular risk (n=84 417); and 18 cohorts with chronic kidney disease (n=91 607).Main outcome measuresGFR decline (estimated GFR decline ≥40%, initiation of kidney replacement therapy or estimated GFR 2) and all cause mortality.ResultsOver a mean follow-up of eight years, 246 607 (5.6%) individuals in the general population cohorts had GFR decline (18 118 (0.4%) end stage kidney disease events) and 782 329 (14.7%) died. Adjusting for age, sex, race, and current smoking, the hazard ratios for GFR decline comparing body mass indices 30, 35, and 40 with body mass index 25 were 1.18 (95% confidence interval 1.09 to 1.27), 1.69 (1.51 to 1.89), and 2.02 (1.80 to 2.27), respectively. Results were similar in all subgroups of estimated GFR. Associations weakened after adjustment for additional comorbidities, with respective hazard ratios of 1.03 (0.95 to 1.11), 1.28 (1.14 to 1.44), and 1.46 (1.28 to 1.67). The association between body mass index and death was J shaped, with the lowest risk at body mass index of 25. In the cohorts with high cardiovascular risk and chronic kidney disease (mean follow-up of six and four years, respectively), risk associations between higher body mass index and GFR decline were weaker than in the general population, and the association between body mass index and death was also J shaped, with the lowest risk between body mass index 25 and 30. In all cohort types, associations between higher waist circumference and higher waist-to-height ratio with GFR decline were similar to that of body mass index; however, increased risk of death was not associated with lower waist circumference or waist-to-height ratio, as was seen with body mass index.ConclusionsElevated body mass index, waist circumference, and waist-to-height ratio are independent risk factors for GFR decline and death in individuals who have normal or reduced levels of estimated GFR.

Published
2019

11. Oestrogen receptors (alpha) and (beta) show different associations to clinicopathological parameters and their co-expression might predict a better response to endocrine treatment in breast cancer

Author

Borqquist, S., Holm, C., Stendahl, M., Anagnostaki, L., Landberg, G., and Jirstrom, K.

Subjects
Breast cancer -- Care and treatment, Hormone therapy -- Patient outcomes, Hormone therapy -- Research, Gene expression -- Analysis, Estrogen -- Receptors, Estrogen -- Genetic aspects, Estrogen -- Physiological aspects, Estrogen -- Research, Health
Published
2008

12. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis

Author

Kovesdy, CP, Matsushita, K, Sang, Y, Brunskill, NJ, Carrero, JJ, Chodick, G, Hasegawa, T, Heerspink, HL, Hirayama, A, Landman, GWD, Levin, A, Nitsch, D, Wheeler, DC, Coresh, J, Hallan, SI, Shalev, V, Grams, ME, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Woodward, M, Arima, H, Perkovic, V, Djurdjev, O, Zhang, L, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Fujii, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Green, J, Kirchner, HL, Chang, AR, Cirillo, Massimo, Jee, SH, Kimm, H, Mok, Y, Wetzels, JFM, Blankestijn, PJ, van Zuilen, Bots, M, Sarnak, M, Inker, L, Roderick, P, Fletcher, A, Bottinger, E, Nadkarni, GN, Ellis, SB, Nadukuru, R, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Gansevoort, RT, Bakker, SJL, Heerspink, HJL, Jassal, SK, Bergstrom, J, Ix, JH, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, de Zeeuw, D, Brenner, B, Gasparini, A, Elinder, CG, Barany, P, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, CP, Tsao, CK, Tsai, MK, Chen, CH, Konta, T, Ichikawa, K, Bilo, HJG, van Hateren, KJJ, Kleefstra, N, Hallan, S, Levey, AS, Ballew, SH, Chen, J, Kwak, L, Woodward, M., Kovesdy, Cp, Matsushita, K, Sang, Y, Brunskill, Nj, Carrero, Jj, Chodick, G, Hasegawa, T, Heerspink, Hl, Hirayama, A, Landman, Gwd, Levin, A, Nitsch, D, Wheeler, Dc, Coresh, J, Hallan, Si, Shalev, V, Grams, Me, Astor, B, Appel, L, Greene, T, Chen, T, Chalmers, J, Woodward, M, Arima, H, Perkovic, V, Djurdjev, O, Zhang, L, Liu, L, Zhao, M, Wang, F, Wang, J, Tang, M, Iso, H, Yamagishi, K, Umesawa, M, Muraki, I, Fukagawa, M, Maruyama, S, Hamano, T, Fujii, N, Wheeler, D, Emberson, J, Townend, J, Landray, M, Green, J, Kirchner, Hl, Chang, Ar, Cirillo, Massimo, Jee, Sh, Kimm, H, Mok, Y, Wetzels, Jfm, Blankestijn, Pj, Van, Zuilen, Ad, Bots, M, Sarnak, M, Inker, L, Roderick, P, Fletcher, A, Bottinger, E, Nadkarni, Gn, Ellis, Sb, Nadukuru, R, Brunskill, N, Major, R, Shepherd, D, Medcalf, J, Gansevoort, Rt, Bakker, Sjl, Heerspink, Hjl, Jassal, Sk, Bergstrom, J, Ix, Jh, Barrett-Connor, E, Kovesdy, C, Kalantar-Zadeh, K, De, Zeeuw, D, Brenner, B, Gasparini, A, Elinder, Cg, Barany, P, Evans, M, Segelmark, M, Stendahl, M, Schön, S, Tangri, N, Sud, M, Naimark, D, Wen, Cp, Tsao, Ck, Tsai, Mk, Chen, Ch, Konta, T, Ichikawa, K, Bilo, Hjg, Van, Hateren, Kjj, Kleefstra, N, Hallan, S, Levey, A, Ballew, Sh, Chen, J, Kwak, L, Woodward, M., Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Groningen Kidney Center (GKC), and Methods in Medicines evaluation & Outcomes research (M2O)

Subjects
Hyperkalemia, 030232 urology & nephrology, HEMODIALYSIS-PATIENTS, Comorbidity, 030204 cardiovascular system & hematology, GLOMERULAR-FILTRATION-RATE, HYPERKALEMIA, End-stage renal disease, CHRONIC RENAL-INSUFFICIENCY, 0302 clinical medicine, SODIUM ZIRCONIUM CYCLOSILICATE, Risk Factors, Cause of Death, Estimated glomerular filtration rate, ESTIMATED GFR, education.field_of_study, Hazard ratio, Middle Aged, Prognosis, CHRONIC HEART-FAILURE, EUROPEAN-SOCIETY, Cardiovascular Diseases, medicine.symptom, Cardiology and Cardiovascular Medicine, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Population, Renal function, Hypokalemia, End stage renal disease, 03 medical and health sciences, Internal medicine, medicine, Humans, Albuminuria, Renal Insufficiency, Chronic, Mortality, education, CKD Prognosis Consortium, Aged, business.industry, Proportional hazards model, POLYMERIC POTASSIUM BINDER, medicine.disease, SERUM POTASSIUM, Potassium, Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Kidney disease
Abstract

Item does not contain fulltext Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium. We used Cox regression followed by random-effects meta-analysis to assess the relationship between baseline potassium and adverse outcomes, adjusted for demographic and clinical characteristics, overall and across strata of estimated glomerular filtration rate (eGFR) and albuminuria. We included 1 217 986 participants followed up for a mean of 6.9 years. The average age was 55 +/- 16 years, average eGFR was 83 +/- 23 mL/min/1.73 m2, and 17% had moderate- to-severe increased albuminuria levels. The mean baseline potassium was 4.2 +/- 0.4 mmol/L. The risk of serum potassium of >5.5 mmol/L was related to lower eGFR and higher albuminuria. The risk relationship between potassium levels and adverse outcomes was U-shaped, with the lowest risk at serum potassium of 4-4.5 mmol/L. Compared with a reference of 4.2 mmol/L, the adjusted hazard ratio for all-cause mortality was 1.22 [95% confidence interval (CI) 1.15-1.29] at 5.5 mmol/L and 1.49 (95% CI 1.26-1.76) at 3.0 mmol/L. Risks were similar by eGFR, albuminuria, renin-angiotensin-aldosterone system inhibitor use, and across cohorts. Conclusions: Outpatient potassium levels both above and below the normal range are consistently associated with adverse outcomes, with similar risk relationships across eGFR and albuminuria.

Published
2018

13. Authors’ response

Author

Borgquist, S, Holm, C, Stendahl, M, Anagnostaki, L, Landberg, G, and Jirström, K

Published
2008

15. Infants Requiring Maintenance Dialysis: Outcomes of Hemodialysis and Peritoneal Dialysis

Author

Vidal, Enrico, primary, van Stralen, Karlijn J., additional, Chesnaye, Nicholas C., additional, Bonthuis, Marjolein, additional, Holmberg, Christer, additional, Zurowska, Aleksandra, additional, Trivelli, Antonella, additional, Da Silva, José Eduardo Esteves, additional, Herthelius, Maria, additional, Adams, Brigitte, additional, Bjerre, Anna, additional, Jankauskiene, Augustina, additional, Miteva, Polina, additional, Emirova, Khadizha, additional, Bayazit, Aysun K., additional, Mache, Christoph J., additional, Sánchez-Moreno, Ana, additional, Harambat, Jérôme, additional, Groothoff, Jaap W., additional, Jager, Kitty J., additional, Schaefer, Franz, additional, Verrina, Enrico, additional, Shtiza, D., additional, Kramar, R., additional, Oberbauer, R., additional, Baiko, S., additional, Sukalo, A., additional, van Hoeck, K., additional, Collart, F., additional, des Grottes, J.M., additional, Pokrajac, D., additional, Roussinov, D., additional, Batinić, D., additional, Lemac, M., additional, Slavicek, J., additional, Seeman, T., additional, Vondrak, K., additional, Heaf, J.G., additional, Toots, U., additional, Finne, P., additional, Grönhagen-Riska, C., additional, Couchoud, C., additional, Lasalle, M., additional, Sahpazova, E., additional, Abazi, N., additional, Ristoka Bojkovska, N., additional, von Gersdorff, G., additional, Scholz, C., additional, Tönshoff, B., additional, Krupka, K., additional, Höcker, B., additional, Pape, L., additional, Afentakis, N., additional, Kapogiannis, A., additional, Printza, N., additional, Reusz, G., additional, Berecki, C.S., additional, Szabó, A., additional, Szabó, T., additional, Györke, Z.S., additional, Kis, E., additional, Palsson, R., additional, Edvardsson, V., additional, Gianoglio, B., additional, Maringhini, S., additional, Pecoraro, C., additional, Picca, S., additional, Testa, S., additional, Rudaitis, S., additional, Said-Conti, V., additional, Gatcan, S., additional, Berbeca, O., additional, Zaikova, N., additional, Pavićević, S., additional, Leivestad, T., additional, Zagozdzon, I., additional, Mota, C., additional, Almeida, M., additional, Afonso, C., additional, Mircescu, G., additional, Garneata, L., additional, Molchanova, E.A., additional, Tomilina, N.A., additional, Bikbov, B.T., additional, Kostic, M., additional, Peco-Antic, A., additional, Spasojevic-Dimitrijeva, B., additional, Milosevski-Lomic, G., additional, Paripovic, D., additional, Puric, S., additional, Kruscic, D., additional, Podracka, L., additional, Kolvek, G., additional, Buturovic-Ponikvar, J., additional, Novljan, G., additional, Battelino, N., additional, Alonso Melgar, A., additional, Schön, S., additional, Prütz, K.G., additional, Backmän, L., additional, Stendahl, M., additional, Evans, M., additional, Rippe, B., additional, Kuenhi, C.E., additional, Maurer, E., additional, Laube, G.F., additional, Tschumi, S., additional, Parvex, P., additional, Hoitsma, A., additional, Hemke, A., additional, Topaloglu, R., additional, Ivanov, D., additional, Pruthi, R., additional, Braddon, F., additional, Mannings, S., additional, Cassula, A., additional, and Sinha, M.D., additional

Published
2017
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16. Kidney Versus Combined Kidney and Liver Transplantation in Young People With Autosomal Recessive Polycystic Kidney Disease: Data From the European Society for Pediatric Nephrology/European Renal Association−European Dialysis and Transplant (ESPN/ERA-EDTA) Registry

Author

Mekahli, Djalila, primary, van Stralen, Karlijn J., additional, Bonthuis, Marjolein, additional, Jager, Kitty J., additional, Balat, Ayşe, additional, Benetti, Elisa, additional, Godefroid, Nathalie, additional, Edvardsson, Vidar O., additional, Heaf, James G., additional, Jankauskiene, Augustina, additional, Kerecuk, Larissa, additional, Marinova, Svetlana, additional, Puteo, Flora, additional, Seeman, Tomas, additional, Zurowska, Aleksandra, additional, Pirenne, Jacques, additional, Schaefer, Franz, additional, Groothoff, Jaap W., additional, Levtchenko, E., additional, Haffner, D., additional, Bjerre, A., additional, Massy, Z., additional, Shtiza, D., additional, Kramar, R., additional, Oberbauer, R., additional, Baiko, S., additional, Sukalo, A., additional, van Hoeck, K., additional, Collart, F., additional, des Grottes, J.M., additional, Pokrajac, D., additional, Roussinov, D., additional, Batinić, D., additional, Lemac, M., additional, Slavicek, J., additional, Seeman, T., additional, Vondrak, K., additional, Heaf, J.G., additional, Toots, U., additional, Finne, P., additional, Grönhagen-Riska, C., additional, Couchoud, C., additional, Lasalle, M, additional, Sahpazova, E, additional, Abazi, N, additional, Ristoka Bojkovska, N, additional, von Gersdorff, G, additional, Scholz, C, additional, Tönshoff, B, additional, Krupka, K, additional, Höcker, B, additional, Pape, L, additional, Afentakis, N, additional, Kapogiannis, A, additional, Printza, N, additional, Reusz, G, additional, Berecki, Cs, additional, Szabó, A, additional, Szabó, T, additional, Györke, Z.S., additional, Kis, E., additional, Palsson, R., additional, Edvardsson, V., additional, Gianoglio, B., additional, Maringhini, S., additional, Pecoraro, C., additional, Picca, S., additional, Testa, S., additional, Vidal, E., additional, Verrina, E., additional, Jankauskiene, A., additional, Pundziene, B., additional, Said-Conti, V., additional, Gatcan, S., additional, Berbeca, O., additional, Zaikova, N., additional, Pavićević, S., additional, Leivestad, T., additional, Zurowska, A., additional, Zagozdzon, I., additional, Mota, C., additional, Almeida, M., additional, Afonso, C., additional, Mircescu, G., additional, Garneata, L., additional, Molchanova, E.A., additional, Tomilina, N.A., additional, Bikbov, B.T., additional, Kostic, M., additional, Peco-Antic, A., additional, Spasojevic-Dimitrijeva, B., additional, Milosevski-Lomic, G., additional, Paripovic, D., additional, Puric, S., additional, Kruscic, D., additional, Podracka, L., additional, Kolvek, G., additional, Buturovic-Ponikvar, J., additional, Novljan, G., additional, Battelino, N., additional, Alonso Melgar, A., additional, Schön, S., additional, Prütz, K.G., additional, Backmän, L., additional, Stendahl, M., additional, Evans, M., additional, Rippe, B., additional, Kuenhi, C.E., additional, Maurer, E., additional, Laube, G.F., additional, Tschumi, S., additional, Parvex, P., additional, Hoitsma, A., additional, Hemke, A., additional, Topaloglu, R., additional, Duzova, A., additional, Ivanov, D., additional, Pruthi, R., additional, Braddon, F., additional, Mannings, S., additional, Cassula, A., additional, and Sinha, M.D., additional

Published
2016
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17. Performance indicators in the wood products industry – a review and study of a saw mill supply chain

Author

Larsson, M., Stendahl, M, and Roos, A.

Subjects
Production Economics, Industrial Organization
Abstract

There is a need for customized tools capable of providing more holistic, integrated information about forest-based SCs. This study evaluates uses (current and potential) of performance indicators (PIs) for enhancing SC management in the wood industry. Literature on PIs in SCs is reviewed, and current use of PIs is analyzed in a survey study. The review distinguished PIs may be related to strategic, tactical or operational levels, and associated time horizons. As illustrated in Table 1, they may be financial (largely related to strategic goals) or non-financial (largely related to operational performance and the behavior of actors). Frameworks and methods for developing PIs depend vary according to the purpose. Goals of performance monitoring are described on retailing, processing and rounwood procurement levels. The case study reveals a clear negative correlation between customer orientation and distance from the market, i.e. a high degree of ‘responsiveness’ at the retailer end and concentration on efficiency at the supplier end of the supply chain. Further studies, including mapping exercises,and the combined effort to identify key performance areas, and developing performance indicators and measurements, are suggested.

Published
2014
Full Text
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19. Clinical Nephrology - Epidemiology II

Author

Agnes, H., primary, Kalman, P., additional, Jozsef, A., additional, Henrik, B., additional, Mucsi, I., additional, Kamata, K., additional, Sano, T., additional, Naito, S., additional, Okamoto, T., additional, Okina, C., additional, Kamata, M., additional, Murano, J., additional, Kobayashi, K., additional, Uchida, M., additional, Aoyama, T., additional, Takeuchi, Y., additional, Nagaba, Y., additional, Sakamoto, H., additional, Torino, C., additional, Panuccio, V., additional, Clementi, A., additional, Garozzo, M., additional, Bonanno, G., additional, Boito, R., additional, Natale, G., additional, Cicchetti, T., additional, Chippari, A., additional, Logozzo, D., additional, Alati, G., additional, Cassani, S., additional, Sellaro, A., additional, D'arrigo, G., additional, Tripepi, G., additional, Roberta, A., additional, Postorino, M., additional, Mallamaci, F., additional, Zoccali, C., additional, Buonanno, E., additional, Brancaccio, S., additional, Fimiani, V., additional, Napolitano, P., additional, Spadola, R., additional, Morrone, L., additional, DI Iorio, B., additional, Russo, D., additional, Betriu, A., additional, Martinez-Alonso, M., additional, Vidal, T., additional, Valdivielso, J., additional, Fernandez, E., additional, Bernadette, F., additional, Jean-Baptiste, B., additional, Frimat, L., additional, Madala, N. D., additional, Thusi, G. P., additional, Sibisi, N., additional, Mazibuko, B. G., additional, Assounga, A. G. H., additional, Tsai, N.-C., additional, Wang, H.-H., additional, Chen, Y.-C., additional, Hung, C.-C., additional, Hwang, S.-J., additional, Chen, H.-C., additional, Branco, P., additional, Adragao, T., additional, Birne, R., additional, Martins, A. R., additional, Vizinho, R., additional, Gaspar, A., additional, Grilo, M. J., additional, Barata, J. D., additional, Bonhorst, D., additional, Adragao, P., additional, Kim, J. S., additional, Yang, J. W., additional, Kim, M. K., additional, Choi, S. O., additional, Han, B. G., additional, Nathalie, N., additional, Sunny, E., additional, Glorieux, G., additional, Daniela, B., additional, Fellype, B., additional, Sophie, L., additional, Horst D, L., additional, Ziad, M., additional, Raymond, V., additional, Yanai, M., additional, Okada, K., additional, Takeuchi, K., additional, Nitta, K., additional, Takahashi, S., additional, Morena, M., additional, Jaussent, I., additional, Halkovich, A., additional, Dupuy, A.-M., additional, Bargnoux, A.-S., additional, Chenine, L., additional, Leray-Moragues, H., additional, Klouche, K., additional, Vernhet, H., additional, Canaud, B., additional, Cristol, J.-P., additional, Shutov, A., additional, Serov, V., additional, Kuznetsova, J., additional, Menzorov, M., additional, Serova, D., additional, Petrescu, L., additional, Zugravu, A., additional, Capusa, C., additional, Stancu, S., additional, Cinca, S., additional, Anghel, C., additional, Timofte, D., additional, Medrihan, L., additional, Ionescu, D., additional, Mircescu, G., additional, Hsu, T.-W., additional, Kuo, K.-L., additional, Hung, S.-C., additional, Tarng, D.-C., additional, Lee, S., additional, Kim, I., additional, Lee, D., additional, Rhee, H., additional, Song, S., additional, Seong, E., additional, Kwak, I., additional, Holzmann, M., additional, Gardell, C., additional, Jeppsson, A., additional, Sartipy, U., additional, Solak, Y., additional, Yilmaz, M. I., additional, Caglar, K., additional, Saglam, M., additional, Yaman, H., additional, Sonmez, A., additional, Unal, H. U., additional, Gok, M., additional, Gaipov, A., additional, Kayrak, M., additional, Eyileten, T., additional, Turk, S., additional, Vural, A., additional, DI Lullo, L., additional, Floccari, F., additional, Rivera, R., additional, Granata, A., additional, D'amelio, A., additional, Logias, F., additional, Otranto, G., additional, Malaguti, M., additional, Santoboni, A., additional, Fiorini, F., additional, Connor, T., additional, Oygar, D., additional, Nitsch, D., additional, Gale, D., additional, Steenkamp, R., additional, Neild, G. H., additional, Maxwell, P., additional, Louise Hogsbro, I., additional, Redal-Baigorri, B., additional, Sautenet, B., additional, Halimi, J. M., additional, Caille, A., additional, Goupille, P., additional, Giraudeau, B., additional, Oguz, Y., additional, Yenicesu, M., additional, Cetinkaya, H., additional, Ishimoto, Y., additional, Ohki, T., additional, Sugahara, M., additional, Kanemitsu, T., additional, Kobayashi, M., additional, Uchida, L., additional, Kotera, N., additional, Tanaka, S., additional, Sugimoto, T., additional, Mise, N., additional, Miyazaki, N., additional, Matsumoto, J., additional, Murata, I., additional, Yoshida, G., additional, Morishita, K., additional, Ushikoshi, H., additional, Nishigaki, K., additional, Ogura, S., additional, Minatoguchi, S., additional, Harvey, R., additional, Ala, A., additional, Banerjee, D., additional, Farmer, C., additional, Irving, J., additional, Hobbs, H., additional, Wheeler, T., additional, Klebe, B., additional, Stevens, P., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Stojcev, N., additional, Gelev, S., additional, Dzekova-Vidimliski, P., additional, Pavleska, S., additional, Sikole, A., additional, Qureshi, A. R., additional, Evans, M., additional, Stendahl, M., additional, Prutz, K. G., additional, Elinder, C. G., additional, Tamagaki, K., additional, Kado, H., additional, Nakata, M., additional, Kitani, T., additional, Ota, N., additional, Ishida, R., additional, Matsuoka, E., additional, Shiotsu, Y., additional, Ishida, M., additional, Mori, Y., additional, Christelle, M., additional, Rognant, N., additional, Evelyne, D., additional, Sophie, F., additional, Laurent, J., additional, Maurice, L., additional, Silverwood, R., additional, Pierce, M., additional, Kuh, D., additional, Savage, C., additional, Ferro, C., additional, Moniek, D. G., additional, De Goeij, M., additional, Nynke, H., additional, Gurbey, O., additional, Joris, R., additional, Friedo, D., additional, Clayton, P., additional, Grace, B., additional, Cass, A., additional, Mcdonald, S., additional, Lorenzo, V., additional, Martin Conde, M., additional, Dusso, A., additional, Valdivielso, J. M., additional, Roggeri, D. P., additional, Cannella, G., additional, Cozzolino, M., additional, Mazzaferro, S., additional, Messa, P., additional, Brancaccio, D., additional, De Souza Faria, R., additional, Fernandes, N., additional, Lovisi, J., additional, Moura Marta, M., additional, Reboredo, M., additional, Do Vale Pinheiro, B., additional, Bastos, M., additional, Hundt, F., additional, Pabst, S., additional, Hammerstingl, C., additional, Gerhardt, T., additional, Skowasch, D., additional, Woitas, R., additional, Lopes, A. A., additional, Silva, L. F., additional, Matos, C. M., additional, Martins, M. S., additional, Silva, F. A., additional, Lopes, G. B., additional, Pizzarelli, F., additional, Dattolo, P., additional, Michelassi, S., additional, Rossi, C., additional, Bandinelli, S., additional, Mieth, M., additional, Mass, R., additional, Ferrucci, L., additional, Parisi, S., additional, Arduino, S., additional, Attini, R., additional, Fassio, F., additional, Biolcati, M., additional, Pagano, A., additional, Bossotti, C., additional, Ferraresi, M., additional, Gaglioti, P., additional, Todros, T., additional, Piccoli, G. B., additional, Salgado, T. M., additional, Arguello, B., additional, Benrimoj, S. I., additional, Fernandez-Llimos, F., additional, Bailey, P., additional, Tomson, C., additional, Ben-Shlomo, Y., additional, Santoro, A., additional, Rucci, P., additional, Mandreoli, M., additional, Caruso, F., additional, Corradini, M., additional, Flachi, M., additional, Gibertoni, D., additional, Rigotti, A., additional, Russo, G., additional, Fantini, M., additional, Mahapatra, H. S., additional, Choudhury, S., additional, Buxi, G., additional, Sharma, N., additional, Gupta, Y., additional, Sekhar, V., additional, Yanagisawa, N., additional, Ando, M., additional, Ajisawa, A., additional, Tsuchiya, K., additional, Janusz, O., additional, Mikolaj, M., additional, Jacek, M., additional, Boleslaw, R., additional, Prakash, S., additional, Coffin, R., additional, Schold, J., additional, Einstadter, D., additional, Stark, S., additional, Rodgers, D., additional, Howard, M., additional, Sehgal, A., additional, Palmer, S., additional, Tong, A., additional, Manns, B., additional, Craig, J., additional, Ruospo, M., additional, Gargano, L., additional, Strippoli, G., additional, Vecchio, M., additional, Petruzzi, M., additional, De Benedictis, M., additional, Pellegrini, F., additional, Ohno, Y., additional, Ishimura, E., additional, Naganuma, T., additional, Kondo, K., additional, Fukushima, W., additional, Mui, K., additional, Inaba, M., additional, Hirota, Y., additional, Sun, X., additional, Jiang, S., additional, Gu, H., additional, Chen, Y., additional, XI, C., additional, Qiao, X., additional, Chen, X., additional, Daher, E., additional, Junior, G. S., additional, Jacinto, C. N., additional, Pimentel, R. S., additional, Aguiar, G. B. R., additional, Lima, C. B., additional, Borges, R. C., additional, Mota, L. P. C., additional, Melo, J. V. L., additional, Melo, S. A., additional, Canamary, V. T., additional, Alves, M., additional, Araujo, S. M. H. A., additional, Huang, Y. K., additional, Rogacev, K., additional, Cremers, B., additional, Zawada, A., additional, Seiler, S., additional, Binder, N., additional, Ege, P., additional, Grosse-Dunker, G., additional, Heisel, I., additional, Hornof, F., additional, Jeken, J., additional, Rebling, N., additional, Ulrich, C., additional, Scheller, B., additional, Bohm, M., additional, Fliser, D., additional, Heine, G. H., additional, Robinson, B., additional, Wang, M., additional, Bieber, B., additional, Fluck, R., additional, Kerr, P. G., additional, Wikstrom, B., additional, Krishnan, M., additional, Nissenson, A., additional, Pisoni, R. L., additional, Mykleset, S., additional, Osthus, T. B., additional, Waldum, B., additional, Os, I., additional, Buttigieg, J., additional, Cassar, A., additional, Farrugia Agius, J., additional, Hara, M., additional, Yamato, M., additional, Yasuda, K., additional, and Sasaki, K., additional

Published
2012
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20. Lineær registrering

Author

Kristensen, O K, Borup, J, Fruergaard-Pedersen, N K, Hansen, E, Johansen, E Ø, Lykke, T, Nielsen, U S, Pedersen, G Aa, and Stendahl, M

Published
1994

24. Performance indicators in the wood products industry – a review and study of a saw mill supply chain

Author

Larsson, M., Stendahl, M, and Roos, A.

Subjects
Industrial Organization, Production Economics
Abstract

There is a need for customized tools capable of providing more holistic, integrated information about forest-based SCs. This study evaluates uses (current and potential) of performance indicators (PIs) for enhancing SC management in the wood industry. Literature on PIs in SCs is reviewed, and current use of PIs is analyzed in a survey study. The review distinguished PIs may be related to strategic, tactical or operational levels, and associated time horizons. As illustrated in Table 1, they may be financial (largely related to strategic goals) or non-financial (largely related to operational performance and the behavior of actors). Frameworks and methods for developing PIs depend vary according to the purpose. Goals of performance monitoring are described on retailing, processing and rounwood procurement levels. The case study reveals a clear negative correlation between customer orientation and distance from the market, i.e. a high degree of ‘responsiveness’ at the retailer end and concentration on efficiency at the supplier end of the supply chain. Further studies, including mapping exercises,and the combined effort to identify key performance areas, and developing performance indicators and measurements, are suggested.

25. Oestrogen receptor β immunohistochemistry: time to get it right?

Author

Borgquist, S., Holm, C., Stendahl, M., Anagnostaki, L., Landberg, G., and Jirström, K.

Subjects
LETTERS to the editor, ESTROGEN receptors
Abstract

A response by S. Borgquist et al. to a letter to the editor about their article "Oestrogen Receptors α and β Show Different Associations to Clinicopathological parameters and Their Co-Expression Might Predict a Better Response to Endocrine Treatment in Breast Cancer" in the 2008 issue is presented.

Published
2008

26. Predicting Kidney Failure, Cardiovascular Disease and Death in Advanced CKD Patients

Author

Chava L. Ramspek, Rosemarijn Boekee, Marie Evans, Olof Heimburger, Charlotte M. Snead, Fergus J. Caskey, Claudia Torino, Gaetana Porto, Maciej Szymczak, Magdalena Krajewska, Christiane Drechsler, Christoph Wanner, Nicholas C. Chesnaye, Kitty J. Jager, Friedo W. Dekker, Maarten G.J. Snoeijs, Joris I. Rotmans, Merel van Diepen, Adamasco Cupisti, Adelia Sagliocca, Alberto Ferraro, Aleksandra Musiała, Alessandra Mele, Alessandro Naticchia, Alex Còsaro, Alistair Woodman, Andrea Ranghino, Andrea Stucchi, Andreas Jonsson, Andreas Schneider, Angelo Pignataro, Anita Schrander, Anke Torp, Anna McKeever, Anna Szymczak, Anna-Lena Blom, Antonella De Blasio, Antonello Pani, Aris Tsalouichos, Asad Ullah, Barbara McLaren, Bastiaan van Dam, Beate Iwig, Bellasi Antonio, Biagio Raffaele Di Iorio, Björn Rogland, Boris Perras, Butti Alessandra, Camille Harron, Carin Wallquist, Carl Siegert, Carla Barrett, Carlo Gaillard, Carlo Garofalo, Cataldo Abaterusso, Charles Beerenhout, Charlotte O'Toole, Chiara Somma, Christian Marx, Christina Summersgill, Christof Blaser, Claudia D'alessandro, Claudia Emde, Claudia Zullo, Claudio Pozzi, Colin Geddes, Cornelis Verburgh, Daniela Bergamo, Daniele Ciurlino, Daria Motta, Deborah Glowski, Deborah McGlynn, Denes Vargas, Detlef Krieter, Domenico Russo, Dunja Fuchs, Dympna Sands, Ellen Hoogeveen, Ellen Irmler, Emöke Dimény, Enrico Favaro, Eva Platen, Ewelina Olczyk, Ewout Hoorn, Federica Vigotti, Ferruccio Ansali, Ferruccio Conte, Francesca Cianciotta, Francesca Giacchino, Francesco Cappellaio, Francesco Pizzarelli, Fredrik Sundelin, Fredrik Uhlin, Gaetano Greco, Geena Roy, Giada Bigatti, Giancarlo Marinangeli, Gianfranca Cabiddu, Gillian Hirst, Giordano Fumagalli, Giorgia Caloro, Giorgina Piccoli, Giovanbattista Capasso, Giovanni Gambaro, Giuliana Tognarelli, Giuseppe Bonforte, Giuseppe Conte, Giuseppe Toscano, Goffredo Del Rosso, Gunilla Welander, Hanna Augustyniak-Bartosik, Hans Boots, Hans Schmidt-Gürtler, Hayley King, Helen McNally, Hendrik Schlee, Henk Boom, Holger Naujoks, Houda Masri-Senghor, Hugh Murtagh, Hugh Rayner, Ilona Miśkowiec-Wiśniewska, Ines Schlee, Irene Capizzi, Isabel Bascaran Hernandez, Ivano Baragetti, Jacek Manitius, Jane Turner, Jan-Willem Eijgenraam, Jeroen Kooman, Joachim Beige, Joanna Pondel, Joanne Wilcox, Jocelyn Berdeprado, Jochen Röthele, Jonathan Wong, Joris Rotmans, Joyce Banda, Justyna Mazur, Kai Hahn, Kamila Jędrzejak, Katarzyna Nowańska, Katja Blouin, Katrin Neumeier, Kirsteen Jones, Kirsten Anding-Rost, Knut-Christian Gröntoft, Lamberto Oldrizzi, Lesley Haydock, Liffert Vogt, Lily Wilkinson, Loreto Gesualdo, Lothar Schramm, Luigi Biancone, Łukasz Nowak, Maarten Raasveld, Magdalena Durlik, Manuela Magnano, Marc Vervloet, Marco Ricardi, Margaret Carmody, Maria Di Bari, Maria Laudato, Maria Luisa Sirico, Maria Stendahl, Maria Svensson, Maria Weetman, Marjolijn van Buren, Martin Joinson, Martina Ferraresi, Mary Dutton, Michael Matthews, Michele Provenzano, Monika Hopf, Moreno Malaguti, Nadja Wuttke, Neal Morgan, Nicola Palmieri, Nikolaus Frischmuth, Nina Bleakley, Paola Murrone, Paul Cockwell, Paul Leurs, Paul Roderick, Pauline Voskamp, Pavlos Kashioulis, Pawlos Ichtiaris, Peter Blankestijn, Petra Kirste, Petra Schulz, Phil Mason, Philip Kalra, Pietro Cirillo, Pietro Dattolo, Pina Acampora, Rincy Sajith, Rita Nigro, Roberto Boero, Roberto Scarpioni, Rosa Sicoli, Rosella Malandra, Sabine Aign, Sabine Cäsar, Sadie van Esch, Sally Chapman, Sandra Biribauer, Santee Navjee, Sarah Crosbie, Sharon Brown, Sheila Tickle, Sherin Manan, Silke Röser, Silvana Savoldi, Silvio Bertoli, Silvio Borrelli, Siska Boorsma, Stefan Heidenreich, Stefan Melander, Stefania Maxia, Stefano Maffei, Stefano Mangano, Stephanie Palm, Stijn Konings, Suresh Mathavakkannan, Susanne Schwedler, Sylke Delrieux, Sylvia Renker, Sylvia Schättel, Szyszkowska Dorota, Teresa Cicchetti, Teresa Nieszporek, Theresa Stephan, Thomas Schmiedeke, Thomas Weinreich, Til Leimbach, Tiziana Rappa, Tora Almquist, Torsten Stövesand, Udo Bahner, Ulrika Jensen, Valentina Palazzo, Walter De Simone, Wolfgang Seeger, Ying Kuan, Zbigniew Heleniak, Zeynep Aydin, Vascular Surgery, MUMC+: MA Med Staf Spec Vaatchirurgie (9), RS: Carim - V03 Regenerative and reconstructive medicine vascular disease, Ramspek, C. L., Boekee, R., Evans, M., Heimburger, O., Snead, C. M., Caskey, F. J., Torino, C., Porto, G., Szymczak, M., Krajewska, M., Drechsler, C., Wanner, C., Chesnaye, N. C., Jager, K. J., Dekker, F. W., Snoeijs, M. G. J., Rotmans, J. I., van Diepen, M., Cupisti, A., Sagliocca, A., Ferraro, A., Musiala, A., Mele, A., Naticchia, A., Cosaro, A., Woodman, A., Ranghino, A., Stucchi, A., Jonsson, A., Schneider, A., Pignataro, A., Schrander, A., Torp, A., Mckeever, A., Szymczak, A., Blom, A. -L., De Blasio, A., Pani, A., Tsalouichos, A., Ullah, A., Mclaren, B., van Dam, B., Iwig, B., Antonio, B., Di Iorio, B. R., Rogland, B., Perras, B., Alessandra, B., Harron, C., Wallquist, C., Siegert, C., Barrett, C., Gaillard, C., Garofalo, C., Abaterusso, C., Beerenhout, C., O'Toole, C., Somma, C., Marx, C., Summersgill, C., Blaser, C., D'Alessandro, C., Emde, C., Zullo, C., Pozzi, C., Geddes, C., Verburgh, C., Bergamo, D., Ciurlino, D., Motta, D., Glowski, D., Mcglynn, D., Vargas, D., Krieter, D., Russo, D., Fuchs, D., Sands, D., Hoogeveen, E., Irmler, E., Dimeny, E., Favaro, E., Platen, E., Olczyk, E., Hoorn, E., Vigotti, F., Ansali, F., Conte, F., Cianciotta, F., Giacchino, F., Cappellaio, F., Pizzarelli, F., Sundelin, F., Uhlin, F., Greco, G., Roy, G., Bigatti, G., Marinangeli, G., Cabiddu, G., Hirst, G., Fumagalli, G., Caloro, G., Piccoli, G., Capasso, G., Gambaro, G., Tognarelli, G., Bonforte, G., Conte, G., Toscano, G., Del Rosso, G., Welander, G., Augustyniak-Bartosik, H., Boots, H., Schmidt-Gurtler, H., King, H., Mcnally, H., Schlee, H., Boom, H., Naujoks, H., Masri-Senghor, H., Murtagh, H., Rayner, H., Miskowiec-Wisniewska, I., Schlee, I., Capizzi, I., Hernandez, I. B., Baragetti, I., Manitius, J., Turner, J., Eijgenraam, J. -W., Kooman, J., Beige, J., Pondel, J., Wilcox, J., Berdeprado, J., Rothele, J., Wong, J., Rotmans, J., Banda, J., Mazur, J., Hahn, K., Jedrzejak, K., Nowanska, K., Blouin, K., Neumeier, K., Jones, K., Anding-Rost, K., Grontoft, K. -C., Oldrizzi, L., Haydock, L., Vogt, L., Wilkinson, L., Gesualdo, L., Schramm, L., Biancone, L., Nowak, L., Raasveld, M., Durlik, M., Magnano, M., Vervloet, M., Ricardi, M., Carmody, M., Di Bari, M., Laudato, M., Sirico, M. L., Stendahl, M., Svensson, M., Weetman, M., van Buren, M., Joinson, M., Ferraresi, M., Dutton, M., Matthews, M., Provenzano, M., Hopf, M., Malaguti, M., Wuttke, N., Morgan, N., Palmieri, N., Frischmuth, N., Bleakley, N., Murrone, P., Cockwell, P., Leurs, P., Roderick, P., Voskamp, P., Kashioulis, P., Ichtiaris, P., Blankestijn, P., Kirste, P., Schulz, P., Mason, P., Kalra, P., Cirillo, P., Dattolo, P., Acampora, P., Sajith, R., Nigro, R., Boero, R., Scarpioni, R., Sicoli, R., Malandra, R., Aign, S., Casar, S., van Esch, S., Chapman, S., Biribauer, S., Navjee, S., Crosbie, S., Brown, S., Tickle, S., Manan, S., Roser, S., Savoldi, S., Bertoli, S., Borrelli, S., Boorsma, S., Heidenreich, S., Melander, S., Maxia, S., Maffei, S., Mangano, S., Palm, S., Konings, S., Mathavakkannan, S., Schwedler, S., Delrieux, S., Renker, S., Schattel, S., Dorota, S., Cicchetti, T., Nieszporek, T., Stephan, T., Schmiedeke, T., Weinreich, T., Leimbach, T., Rappa, T., Almquist, T., Stovesand, T., Bahner, U., Jensen, U., Palazzo, V., De Simone, W., Seeger, W., Kuan, Y., Heleniak, Z., Aydin, Z., Medical Informatics, APH - Aging & Later Life, APH - Methodology, APH - Quality of Care, Nephrology, ACS - Microcirculation, APH - Health Behaviors & Chronic Diseases, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, ACS - Diabetes & metabolism, and Internal Medicine

Subjects
SDG 3 - Good Health and Well-being, external validation, Nephrology, cardiovascular disease, death, CKD, kidney failure, prognostic model
Abstract

Introduction: Predicting the timing and occurrence of kidney replacement therapy (KRT), cardiovascular events, and death among patients with advanced chronic kidney disease (CKD) is clinically useful and relevant. We aimed to externally validate a recently developed CKD G4+ risk calculator for these outcomes and to assess its potential clinical impact in guiding vascular access placement. Methods: We included 1517 patients from the European Quality (EQUAL) study, a European multicentre prospective cohort study of nephrology-referred advanced CKD patients aged ≥65 years. Model performance was assessed based on discrimination and calibration. Potential clinical utility for timing of referral for vascular access placement was studied with diagnostic measures and decision curve analysis (DCA). Results: The model showed a good discrimination for KRT and “death after KRT,” with 2-year concordance (C) statistics of 0.74 and 0.76, respectively. Discrimination for cardiovascular events (2-year C-statistic: 0.70) and overall death (2-year C-statistic: 0.61) was poorer. Calibration was fairly accurate. Decision curves illustrated that using the model to guide vascular access referral would generally lead to less unused arteriovenous fistulas (AVFs) than following estimated glomerular filtration rate (eGFR) thresholds. Conclusion: This study shows moderate to good predictive performance of the model in an older cohort of nephrology-referred patients with advanced CKD. Using the model to guide referral for vascular access placement has potential in combating unnecessary vascular surgeries.

Published
2022

27. Associations between depressive symptoms and disease progression in older patients with chronic kidney disease

Author

Eveleens Maarse, Boukje C., Chesnaye, Nicholas C., Robbert, Schouten, Michels, Wieneke M., Bos, Willem Jan W., Maciej, Szymczak, Magdalena, Krajewska, Marie Evans, Olof Heimburger, Caskey, Fergus J., Christoph, Wanner, Jager, Kitty J., Dekker, Friedo W., Yvette, Meuleman, Andreas, Schneider, Anke, Torp, Beate, Iwig, Boris, Perras, Christian, Marx, Christiane, Drechsler, Christof, Blaser, Claudia, Emde, Detlef, Krieter, Dunja, Fuchs, Ellen, Irmler, Eva, Platen, Hans, Schmidt-Gürtler, Hendrik, Schlee, Holger, Naujoks, Ines, Schlee, Sabine, Cäsar, Joachim, Beige, Jochen, Röthele, Justyna, Mazur, Kai, Hahn, Katja, Blouin, Katrin, Neumeier, Kirsten, Anding-Rost, Lothar, Schramm, Monika, Hopf, Nadja, Wuttke, Nikolaus, Frischmuth, Pawlos, Ichtiaris, Petra, Kirste, Petra, Schulz, Sabine, Aign, Sandra, Biribauer, Sherin, Manan, Silke, Röser, Stefan, Heidenreich, Stephanie, Palm, Susanne, Schwedler, Sylke, Delrieux, Sylvia, Renker, Sylvia, Schättel, Theresa, Stephan, Thomas, Schmiedeke, Thomas, Weinreich, Til, Leimbach, Torsten, Stövesand, Udo, Bahner, Wolfgang, Seeger, Cupisti, Adamasco, Adelia, Sagliocca, Alberto, Ferraro, Alessandra, Mele, Alessandro, Naticchia, Alex, Còsaro, Andrea, Ranghino, Andrea, Stucchi, Angelo, Pignataro, Antonella De Blasio, Antonello, Pani, Aris, Tsalouichos, Bellasi, Antonio, Biagio Raffaele Di Iorio, Butti, Alessandra, Cataldo, Abaterusso, Chiara, Somma, Claudia, D'Alessandro, Claudia, Torino, Claudia, Zullo, Claudio, Pozzi, Daniela, Bergamo, Daniele, Ciurlino, Daria, Motta, Domenico, Russo, Enrico, Favaro, Federica, Vigotti, Ferruccio, Ansali, Ferruccio, Conte, Francesca, Cianciotta, Francesca, Giacchino, Francesco, Cappellaio, Francesco, Pizzarelli, Gaetano, Greco, Gaetana, Porto, Giada, Bigatti, Giancarlo, Marinangeli, Gianfranca, Cabiddu, Giordano, Fumagalli, Giorgia, Caloro, Giorgina, Piccoli, Giovanbattista, Capasso, Giovanni, Gambaro, Giuliana, Tognarelli, Giuseppe, Bonforte, Giuseppe, Conte, Giuseppe, Toscano, Goffredo Del Rosso, Irene, Capizzi, Ivano, Baragetti, Lamberto, Oldrizzi, Loreto, Gesualdo, Luigi, Biancone, Manuela, Magnano, Marco, Ricardi, Maria Di Bari, Maria, Laudato, Maria Luisa Sirico, Martina, Ferraresi, Maurizio, Postorino, Michele, Provenzano, Moreno, Malaguti, Nicola, Palmieri, Paola, Murrone, Pietro, Cirillo, Pietro, Dattolo, Pina, Acampora, Rita, Nigro, Roberto, Boero, Roberto, Scarpioni, Rosa, Sicoli, Rosella, Malandra, Silvana, Savoldi, Silvio, Bertoli, Silvio, Borrelli, Stefania, Maxia, Stefano, Maffei, Stefano, Mangano, Teresa, Cicchetti, Tiziana, Rappa, Valentina, Palazzo, Walter De Simone, Anita, Schrander, Bastiaan van Dam, Carl, Siegert, Carlo, Gaillard, Charles, Beerenhout, Cornelis, Verburgh, Cynthia, Janmaat, Ellen, Hoogeveen, Ewout, Hoorn, Friedo, Dekker, Johannes, Boots, Henk, Boom, Jan-Willem, Eijgenraam, Jeroen, Kooman, Joris, Rotmans, Kitty, Jager, Liffert, Vogt, Maarten, Raasveld, Marc, Vervloet, Marjolijn van Buren, Merel van Diepen, Nicholas, Chesnaye, Paul, Leurs, Pauline, Voskamp, Peter, Blankestijn, Sadie van Esch, Siska, Boorsma, Stefan, Berger, Constantijn, Konings, Zeynep, Aydin, Aleksandra, Musiała, Anna, Szymczak, Ewelina, Olczyk, Hanna, Augustyniak-Bartosik, Ilona, Miśkowiec-Wiśniewska, Jacek, Manitius, Joanna, Pondel, Kamila, Jędrzejak, Katarzyna, Nowańska, Łukasz, Nowak, Magdalena, Durlik, Szyszkowska, Dorota, Teresa, Nieszporek, Zbigniew, Heleniak, Andreas, Jonsson, Anna-Lena, Blom, Björn, Rogland, Carin, Wallquist, Denes, Vargas, Emöke, Dimény, Fredrik, Sundelin, Fredrik, Uhlin, Gunilla, Welander, Isabel Bascaran Hernandez, Knut-Christian, Gröntoft, Maria, Stendahl, Maria, Svensson, Marie, Evans, Olof, Heimburger, Pavlos, Kashioulis, Stefan, Melander, Tora, Almquist, Ulrika, Jensen, Alistair, Woodman, Anna, Mckeever, Asad, Ullah, Barbara, Mclaren, Camille, Harron, Carla, Barrett, Charlotte, O'Toole, Christina, Summersgill, Colin, Geddes, Deborah, Glowski, Deborah, Mcglynn, Dympna, Sands, Fergus, Caskey, Geena, Roy, Gillian, Hirst, Hayley, King, Helen, Mcnally, Houda, Masri-Senghor, Hugh, Murtagh, Hugh, Rayner, Jane, Turner, Joanne, Wilcox, Jocelyn, Berdeprado, Jonathan, Wong, Joyce, Banda, Kirsteen, Jones, Lesley, Haydock, Lily, Wilkinson, Margaret, Carmody, Maria, Weetman, Martin, Joinson, Mary, Dutton, Michael, Matthews, Neal, Morgan, Nina, Bleakley, Paul, Cockwell, Paul, Roderick, Phil, Mason, Philip, Kalra, Rincy, Sajith, Sally, Chapman, Santee, Navjee, Sarah, Crosbie, Sharon, Brown, Sheila, Tickle, Suresh, Mathavakkannan, Ying, Kuan, Internal medicine, Nephrology, ACS - Diabetes & metabolism, Medical Informatics, APH - Methodology, APH - Aging & Later Life, Graduate School, APH - Quality of Care, ACS - Microcirculation, APH - Health Behaviors & Chronic Diseases, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, Eveleens Maarse, B. C., Chesnaye, N. C., Schouten, R., Michels, W. M., Bos, W. J. W., Szymczak, M., Krajewska, M., Evans, M., Heimburger, O., Caskey, F. J., Wanner, C., Jager, K. J., Dekker, F. W., Meuleman, Y., Schneider, A., Torp, A., Iwig, B., Perras, B., Marx, C., Drechsler, C., Blaser, C., Emde, C., Krieter, D., Fuchs, D., Irmler, E., Platen, E., Schmidt-Gurtler, H., Schlee, H., Naujoks, H., Schlee, I., Casar, S., Beige, J., Rothele, J., Mazur, J., Hahn, K., Blouin, K., Neumeier, K., Anding-Rost, K., Schramm, L., Hopf, M., Wuttke, N., Frischmuth, N., Ichtiaris, P., Kirste, P., Schulz, P., Aign, S., Biribauer, S., Manan, S., Roser, S., Heidenreich, S., Palm, S., Schwedler, S., Delrieux, S., Renker, S., Schattel, S., Stephan, T., Schmiedeke, T., Weinreich, T., Leimbach, T., Stovesand, T., Bahner, U., Seeger, W., Cupisti, A., Sagliocca, A., Ferraro, A., Mele, A., Naticchia, A., Cosaro, A., Ranghino, A., Stucchi, A., Pignataro, A., De Blasio, A., Pani, A., Tsalouichos, A., Antonio, B., Raffaele Di Iorio, B., Alessandra, B., Abaterusso, C., Somma, C., D'Alessandro, C., Torino, C., Zullo, C., Pozzi, C., Bergamo, D., Ciurlino, D., Motta, D., Russo, D., Favaro, E., Vigotti, F., Ansali, F., Conte, F., Cianciotta, F., Giacchino, F., Cappellaio, F., Pizzarelli, F., Greco, G., Porto, G., Bigatti, G., Marinangeli, G., Cabiddu, G., Fumagalli, G., Caloro, G., Piccoli, G., Capasso, G., Gambaro, G., Tognarelli, G., Bonforte, G., Conte, G., Toscano, G., Del Rosso, G., Capizzi, I., Baragetti, I., Oldrizzi, L., Gesualdo, L., Biancone, L., Magnano, M., Ricardi, M., Di Bari, M., Laudato, M., Luisa Sirico, M., Ferraresi, M., Postorino, M., Provenzano, M., Malaguti, M., Palmieri, N., Murrone, P., Cirillo, P., Dattolo, P., Acampora, P., Nigro, R., Boero, R., Scarpioni, R., Sicoli, R., Malandra, R., Savoldi, S., Bertoli, S., Borrelli, S., Maxia, S., Maffei, S., Mangano, S., Cicchetti, T., Rappa, T., Palazzo, V., De Simone, W., Schrander, A., Van Dam, B., Siegert, C., Gaillard, C., Beerenhout, C., Verburgh, C., Janmaat, C., Hoogeveen, E., Hoorn, E., Boots, J., Boom, H., Eijgenraam, J. -W., Kooman, J., Rotmans, J., Vogt, L., Raasveld, M., Vervloet, M., Van Buren, M., Van Diepen, M., Leurs, P., Voskamp, P., Blankestijn, P., Van Esch, S., Boorsma, S., Berger, S., Konings, C., Aydin, Z., Musiala, A., Szymczak, A., Olczyk, E., Augustyniak-Bartosik, H., Miskowiec-Wisniewska, I., Manitius, J., Pondel, J., Jedrzejak, K., Nowanska, K., Nowak, L., Durlik, M., Dorota, S., Nieszporek, T., Heleniak, Z., Jonsson, A., Blom, A. -L., Rogland, B., Wallquist, C., Vargas, D., Dimeny, E., Sundelin, F., Uhlin, F., Welander, G., Bascaran Hernandez, I., Grontoft, K. -C., Stendahl, M., Svensson, M., Kashioulis, P., Melander, S., Almquist, T., Jensen, U., Woodman, A., Mckeever, A., Ullah, A., Mclaren, B., Harron, C., Barrett, C., O'Toole, C., Summersgill, C., Geddes, C., Glowski, D., Mcglynn, D., Sands, D., Roy, G., Hirst, G., King, H., Mcnally, H., Masri-Senghor, H., Murtagh, H., Rayner, H., Turner, J., Wilcox, J., Berdeprado, J., Wong, J., Banda, J., Jones, K., Haydock, L., Wilkinson, L., Carmody, M., Weetman, M., Joinson, M., Dutton, M., Matthews, M., Morgan, N., Bleakley, N., Cockwell, P., Roderick, P., Mason, P., Kalra, P., Sajith, R., Chapman, S., Navjee, S., Crosbie, S., Brown, S., Tickle, S., Mathavakkannan, S., and Kuan, Y.

Subjects
Transplantation, prospective cohort study, depressive symptoms, nephrology care, Nephrology, clinical outcome, chronic kidney disease, clinical trial, epidemiology, joint model, survival analysis, depressive symptom
Abstract

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (≥65 years; estimated glomerular filtration rate ≤20 mL/min/1.73 m2) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off ≤70; 0–100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was –0.12 mL/min/1.73 m2/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03–1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men.

Published
2022

28. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe

Author

Pablo Castro de la Nuez, Ángela Magaz, Harijs Cernevskis, Arjan van der Tol, Kirill Komissarov, Maria Fernanda Slon Roblero, Edita Ziginskiene, Nino Kantaria, Manuela Savino, Jaakko Helve, Kyriakos Ioannou, Olivera Stojceva-Taneva, Kitty J Jager, Johan De Meester, Helena Rydell, Mai Ots-Rosenberg, Faical Jarraya, Myftar Barbullushi, Bjørn Odvar Eriksen, Rianne W de Jong, Cécile Couchoud, Axel Rahmel, Samira Bell, Lucile Mercadal, Eliezer Golan, Marc H Hemmelder, José Baltar, Anton M. Andrusev, Vianda S. Stel, Nurhan Seyahi, Anneke Kramer, Julia Kerschbaum, Liliana Gârneaţă, Ziad A. Massy, Kristine Hommel, Runolfur Palsson, Evgueniy Vazelov, Oscar Zurriaga, Raymond Vanholder, HUS Abdominal Center, Nefrologian yksikkö, Department of Medicine, University of Helsinki, Helsinki University Hospital Area, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Agence de la biomédecine [Saint-Denis la Plaine], Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de néphrologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Ambroise Paré [AP-HP], Recycled Materials Resource Center, RMRC Comunidad de Madrid Sociedad Española de Nefrología, SEN European Commission, EC: PP-01-2016 Universidade Paranaense, UNIPAR European Renal Association-European Dialysis and Transplant Association, ERA-EDTA, The authors would like to thank the patients and staff of all the dialysis and transplant units who have contributed data via their national and regional renal registries to the European Renal Association?European Dialysis and Transplant Association (ERA-EDTA) Registry. In addition, we would like to thank the persons and organizations listed in the paragraph ?AFFILIATED REGISTRIES? for their contribution to the work of the ERA-EDTA Registry. The authors are grateful to all nephrologists and kidney transplant surgeons who completed ?The Effect of Differing Kidney Disease Treatment Modalities and Organ Donation and Transplantation Practices on Health Expenditure and Patient Outcomes? Nephrologist survey. In addition, we would like to thank all colleagues who pretested the survey, provided advice about the ethical approval in their country, or helped to distribute the survey in their country or personal network. This study was funded by the European Union (grant PP-01-2016) and ERA-EDTA. Among others, we are grateful for support from Austria (R. Kramar and R. Oberbauer), Belarus, Belgium (F. Collart), Croatia (I. Bubic, M. Bu?i?, M. Dragovi?, and S. ?iv?i? ?osi?), Cyprus, Czech Republic (I. Rychlik and V. Tesa?), Denmark (J. Heaf and S. Schwartz S?rensen), Estonia, Finland (P. Finne and V. Rauta), Germany (M. Lingemann and C. Wanner), Greece (T. Apostolou, E. Dounousi, and G. Moustakas), Hungary (O. Deme, S. Mihaly, and G. Re?sz), Ireland (W. Plant), Italy (G. Brunori, C. Carella, P. di Ciaccio, and M. Postorino), Latvia (A. Petersons), Malta (J. Buttigieg), Moldova (A. Tanase), the Netherlands (F. van Ittersum and S. Logtenberg), North Macedonia (G. Spasovski), Norway (A. ?sberg, M. Dahl Solbu, and A. Varberg Reis?ter), Poland (S. Dudzicz and M. Nowicki), Romania (L. G?rnea?? and L. Tuta), Russia (H. Zakharova), Serbia (R. Naumovic), Slovakia (V. Spustova), Slovenia (J. Buturovic Ponikvar and D. Kovac), Spain (C. Alberich, J. Comas, M. del Pino y Pino, M. Ferrer Alamar, and B. Mahillo), Sweden (M. Evans), Switzerland (P. Amb?hl and U. Huynh-Do), Turkey (M. Arici), Ukraine (M. Kolesnyk), and United Kingdom (S. Fraser and G. Lipkin), and from the following organizations: EKITA (I. Bellini and R. Langer), ERA-EDTA (F. Trebelli), EuroPD (S. Davies), and Eurotransplant (P. Branger, M. van Meel, and U. Samuel). Affiliated registries. Albanian Renal Registry (M. Barbullushi, A. Idrizi, and E. Bolleku Likaj), Austrian Dialysis and Transplant Registry (OEDTR) (R. Kramar), Belarus Renal Registry (K.S. Komissarov, K.S. Kamisarau, and A.V. Kalachyk), Dutch-speaking Belgian Society of Nephrology (NBVN) (M. Couttenye, F. Schroven, and J. De Meester), French-speaking Belgian Society of Nephrology (GNFB) (J.M. des Grottes and F. Collart), Renal Registry Bosnia and Herzegovina (H. Resi?, Z. Stipancic, and N. Petkovic), Bulgaria (E.S. Vazelov and I. Velinova), Croatian Registry of renal replacement therapy (CRRRT) (I. Bubi? and M. Knotek), Cyprus Renal Registry (K. Ioannou and all of the renal units providing data), Czech Republic: Registry of Dialysis Patients (RDP) (I. Rychl?k, J. Potucek, and F. Lopot), Danish Nephrology Registry (DNS) (J.G. Heaf), Estonian Society of Nephrology (?. Pechter, K. Lilienthal, and M. Rosenberg), Finnish Registry for Kidney Diseases (P. Finne, A. Pylsy, and P.H. Groop), France: The Epidemiology and Information Network in Nephrology (REIN) (M. Lassalle and C. Couchoud), Georgian Renal Registry (N. Kantaria and Dialysis Nephrology and Transplantation Union of Georgia), Hellenic Renal Registry (N. Afentakis), Icelandic ESRD Registry (R. Palsson), Israel National Registry of Renal Replacement Therapy (R. Dichtiar, T. Shohat, and E. Golan), Italian Registry of Dialysis and Transplantation (RIDT) (A. Limido, M. Nordio, and M. Postorino), Latvian Renal Registry (H. Cernevskis, V. Kuzema, and A. Silda), Lithuanian Renal Registry (I.A. Bumblyte, V. Vainauskas, and E. ?iginskien?), Macedonian Renal Registry (M. Nedelkovska, N. Dimitriova, and O. Stojceva-Taneva), Norwegian Renal Registry (T. Leivestad, A.V. Reis?ter, and A. ?sberg), Polish Renal Registry (G. Korejwo, A. D?bska-?lizie?, and R. Gellert), Portuguese Renal Registry (F. Mac?rio and A. Ferreira), Romanian Renal Registry (RRR) (G. Mircescu, L. Garneata, and E. Podgoreanu), Russian Renal Registry (N. Tomilina, A. Andrusev, and H. Zakharova), Renal Registry in Serbia (N. Maksimovic, R. Naumovic, all of the Serbian renal units, and the Serbian Society of Nephrology), Slovakian Renal Registry (V. Spustov?, I. Lajdov?, and M. Karolyova), Spanish RRT National Registry at Organizaci?n Nacional de Trasplantes (ONT), Spanish Regional Registries, Spanish Society of Nephrology (SEN), and the regional registries of Andalusia Sistema de Informaci?n de la Coordinaci?n Auton?mica de Trasplantes de Andalucia (SICATA) (P. Castro de la Nuez [on behalf of all users of SICATA]), Aragon (F. Arribas Monz?n, J.M. Abad Diez, and J.I. Sanchez Miret), Asturias (R. Alonso de la Torre, J.R. Quir?s, and Registro de Enfermos Renales Cr?nicos de Asturias [RERCA] Working Group), Basque country (UNIPAR) (?. Magaz, J. Aranzabal, M. Rodrigo, and I. Moina), Cantabria (J.C. Ruiz San Mill?n, O. Garcia Ruiz, and C. Pi?era Haces), Castile and Le?n (M.A. Palencia Garc?a), Castile?La Mancha (G. Guti?rrez ?vila and I. Moreno Al?a), Catalonia (RMRC) (E. Arcos, J. Comas, and J. Tort), Extremadura (J.M. Ramos Aceitero and M.A. Garc?a Bazaga), Galicia (E. Bouzas-Caama?o), Community of Madrid (M.I. Aparicio de Madre), Renal Registry of the Region of Murcia (C. Santiuste de Pablos and I. Mar?n S?nchez), Navarre (M.F. Slon Roblero, J. Manrique Escola, and J. Arteaga Coloma), and the Valencian region (REMRENAL) (M. Ferrer Alamar, N. Fuster Camarena, and J. P?rez Penad?s), Swedish Renal Registry (SNR) (K.G. Pr?tz, M. Stendahl, M. Evans, S. Sch?n, T. Lundgren, and M. Segelmark), Swiss Dialysis Registry (P. Amb?hl and R. Winzeler), Dutch Renal Registry (RENINE) (L. Heuveling, S. Vogelaar, and M. Hemmelder), Tunisia, Sfax region (F. Jarraya and D. Zalila), Registry of the Nephrology, Dialysis and Transplantation in Turkey (TSNNR) (G. S?leymanlar, N. Seyahi, and K. Ate?), Ukrainian Renal Data System (URDS) (M. Kolesnyk, S. Nikolaenko, and O. Razvazhaieva), UK Renal Registry (UKRR) (all the staff of the UKRR and of the renal units submitting data), and Scottish Renal Registry (SRR) (all of the Scottish renal units). ERA-EDTA Registry committee members. C. Zoccali, Italy (ERA-EDTA President), Z.A. Massy, France (Chairman), F.J. Caskey, United Kingdom, C. Couchoud, France, M. Evans, Sweden, P. Finne, Finland, J.W. Groothoff, the Netherlands, J. Harambat, France, J.G. Heaf, Denmark, F. Jarraya, Tunisia, M. Nordio, Italy, and I. Rychlik, Czech Republic., Service de Néphrologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, Graduate School, APH - Methodology, ACS - Pulmonary hypertension & thrombosis, APH - Global Health, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
0301 basic medicine, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Conservative Treatment, DISEASE, 0302 clinical medicine, Germany, Medicine and Health Sciences, Registries, Renal Insufficiency, Kidney transplantation, education.field_of_study, hemodialysis, Greece, RENAL REPLACEMENT THERAPY, 3. Good health, Europe, peritoneal dialysis, Italy, Nephrology, Hemodialysis, medicine.medical_specialty, Population, hemodialysis [Keywords], Peritoneal dialysis, 03 medical and health sciences, Renal Dialysis, Internal medicine, medicine, Humans, Renal replacement therapy, education, Dialysis, Edetic Acid, Portugal, business.industry, Home hemodialysis, CARE, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Kidney Transplantation, Transplantation, 030104 developmental biology, Spain, Kidney Failure, Chronic, DONATION, business, Ireland, transplantation
Abstract

The aims of this study were to determine the frequency of dialysis and kidney transplantation and to estimate the regularity of comprehensive conservative management (CCM) for patients with kidney failure in Europe. This study uses data from the ERA-EDTA Registry. Additionally, our study included supplemental data from Armenia, Germany, Hungary, Ireland, Kosovo, Luxembourg, Malta, Moldova, Montenegro, Slovenia and additional data from Israel, Italy, Slovakia using other information sources. Through an online survey, responding nephrologists estimated the frequency of CCM (i.e. planned holistic care instead of kidney replacement therapy) in 33 countries. In 2016, the overall incidence of replacement therapy for kidney failure was 132 per million population (pmp), varying from 29 (Ukraine) to 251 pmp (Greece). On 31 December 2016, the overall prevalence of kidney replacement therapy was 985 pmp, ranging from 188 (Ukraine) to 1906 pmp (Portugal). The prevalence of peritoneal dialysis (114 pmp) and home hemodialysis (28 pmp) was highest in Cyprus and Denmark respectively. The kidney transplantation rate was nearly zero in some countries and highest in Spain (64 pmp). In 28 countries with five or more responding nephrologists, the median percentage of candidates for kidney replacement therapy who were offered CCM in 2018 varied between none (Slovakia and Slovenia) and 20% (Finland) whereas the median prevalence of CCM varied between none (Slovenia) and 15% (Hungary). Thus, the substantial differences across Europe in the frequency of kidney replacement therapy and CCM indicate the need for improvement in access to various treatment options for patients with kidney failure. European UnionEuropean Commission [PP-01-2016]; ERAEDTA This study was funded by the European Union (grant PP-01-2016) and ERAEDTA.

Published
2020

30. Survival of patients treated with extended-hours haemodialysis in Europe: an analysis of the ERA-EDTA Registry

Author

Eric Laruelle, Brigit C. van Jaarsveld, Kitty J Jager, Frederic Collart, Helena Rydell, Cécile Couchoud, Aleix Cases, Jamie P. Traynor, Thijs T. Jansz, Jaakko Helve, Mustafa Arici, Ziad A. Massy, Marlies Noordzij, Carmine Zoccali, Anneke Kramer, Bård Waldum-Grevbo, CHU Pontchaillou [Rennes], Agence de la biomédecine [Saint-Denis la Plaine], Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Ambroise Paré [AP-HP], European Renal Association-European Dialysis and Transplant Association, ERA-EDTA, We would like to thank the patients and the staff of the dialysis and transplant units for contributing the data via their national and regional renal registries. Furthermore, we gratefully acknowledge the following registries and persons for their contributions of data: Austrian Dialysis and Transplant Registry (R. Kramar), French-speaking Belgian Society of Nephrology (J.M. des Grottes), Finnish Registry for Kidney Diseases (P. Finne, A. Pylsy and P.H. Groop), France: The Epidemiology and Information Network in Nephrology (REIN) (M. Lassalle), Norwegian Renal Registry (T. Leivestad, A.V. Reisæter and A. Åsberg), Swedish Renal Registry (K.G. Prütz, M. Stendahl, M. Evans, S. Schön, T. Lundgren and M. Segelmark), Scottish Renal Registry (all of the Scottish renal units), and the regional registry of Catalonia (E. Arcos, J. Comas and J. Tort) and the other ERA-EDTA Registry Committee members not mentioned above for their advice in the analysis and the drafting of this article: P. Ambühl, J. De Meester, M. Evans, P. Finne, J. Harambat, L. Mercadal, M. Nordio, S.S. Sørensen and E. Vidal, and M. Pippias and V.S. Stel in the AMC Registry office for data collection and management. The ERA-EDTA Registry is funded by the ERA-EDTA. This article was written by T. Jansz, M. Noordzij, A. Kramer, E. Laruelle, C. Couchoud, F. Collart, A. Cases, M. Arici, J. Helve, B. Waldum-Grevbo, H. Rydell, J. Traynor, C. Zoccali, Z.A. Massy, K.J. Jager and B.C. van Jaarsveld on behalf of the ERA-EDTA Registry, which is an official body of the ERA-EDTA., HUS Abdominal Center, Department of Medicine, Nefrologian yksikkö, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, APH - Methodology, Nephrology, ACS - Diabetes & metabolism, and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, Registries, nocturnal haemodialysis, Mortality rate, Hazard ratio, RENAL REPLACEMENT THERAPY, Middle Aged, Prognosis, DIALYSIS OUTCOMES, Hemodiàlisi, 3. Good health, Europe, Survival Rate, haemodialysis, Nephrology, Hemodialysis, ERA-EDTA Registry, Female, PRACTICE PATTERNS, INTENSIVE HEMODIALYSIS, medicine.medical_specialty, survival, 03 medical and health sciences, MORTALITY RISK, Renal Dialysis, LEFT-VENTRICULAR MASS, Internal medicine, medicine, Mortalitat, Humans, Renal replacement therapy, Mortality, Dialysis, Aged, Transplantation, HOME HEMODIALYSIS, CONVENTIONAL HEMODIALYSIS, business.industry, Proportional hazards model, Home hemodialysis, KIDNEY-DISEASE, Original Articles, 3126 Surgery, anesthesiology, intensive care, radiology, Confidence interval, Kidney Failure, Chronic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, extended-hours, business, CENTER NOCTURNAL HEMODIALYSIS
Abstract

Background Previous US studies have indicated that haemodialysis with ≥6-h sessions [extended-hours haemodialysis (EHD)] may improve patient survival. However, patient characteristics and treatment practices vary between the USA and Europe. We therefore investigated the effect of EHD three times weekly on survival compared with conventional haemodialysis (CHD) among European patients. Methods We included patients who were treated with haemodialysis between 2010 and 2017 from eight countries providing data to the European Renal Association–European Dialysis and Transplant Association Registry. Haemodialysis session duration and frequency were recorded once every year or at every change of haemodialysis prescription and were categorized into three groups: CHD (three times weekly, 3.5–4 h/treatment), EHD (three times weekly, ≥6 h/treatment) or other. In the primary analyses we attributed death to the treatment at the time of death and in secondary analyses to EHD if ever initiated. We compared mortality risk for EHD to CHD with causal inference from marginal structural models, using Cox proportional hazards models weighted for the inverse probability of treatment and censoring and adjusted for potential confounders. Results From a total of 142 460 patients, 1338 patients were ever treated with EHD (three times, 7.1 ± 0.8 h/week) and 89 819 patients were treated exclusively with CHD (three times, 3.9 ± 0.2 h/week). Crude mortality rates were 6.0 and 13.5/100 person-years. In the primary analyses, patients treated with EHD had an adjusted hazard ratio (HR) of 0.73 [95% confidence interval (CI) 0.62–0.85] compared with patients treated with CHD. When we attributed all deaths to EHD after initiation, the HR for EHD was comparable to the primary analyses [HR 0.80 (95% CI 0.71–0.90)]. Conclusions EHD is associated with better survival in European patients treated with haemodialysis three times weekly.

Published
2019

31. Maximum Strength and Power as Determinants of Match Skating Performance in Elite Youth Ice Hockey Players.

Author

Keiner M, Kierot M, Stendahl M, Brauner T, and Suchomel TJ

Subjects
Humans, Male, Cross-Sectional Studies, Adolescent, Skating physiology, Hockey physiology, Athletic Performance physiology, Muscle Strength physiology
Abstract

Abstract: Keiner, M, Kierot, M, Stendahl, M, Brauner, T, and Suchomel, TJ. Maximum strength and power as determinants of match skating performance in elite youth ice hockey players. J Strength Cond Res 38(6): 1090-1094, 2024-Maximum strength has a strong influence on speed-strength performances such as sprints and jumps. Important for sports practice is whether these findings are also reflected in game performance. Therefore, the aim of this study was to explore the influence of maximum strength and power performance on linear on-ice skating performance in testing and during game play. A cross-sectional study was conducted, and 24 highly trained male youth ice hockey players participated. Jump performances (countermovement jump [CMJ], drop jumps), maximum strength (1 repetition maximum [1RM] squat and isometric trap bar pull [ITBP]), and on-ice linear sprints (15 m [LS15], 30 m [LS30], flying 15 m [FLY15]) were measured. Match performances (among others: peak skating speed) were collected of 4 regular league games using a local positioning system. Correlation coefficient and explained variance were calculated ( ρ ≤ 0.05). Correlations between maximum strength and jump with on-ice linear sprint performance showed 1-35% explained variance. Correlations between "off ice" test (CMJ, relative 1RM) and game data (peak skating speed) showed 22-30% explained variance, respectively, while ITBP and DJ missed significant level. Between linear sprint and game performance showed 15-59% explained variance. In this study, a clear influence of 1RM in squatting and CMJ performance on on-ice linear sprint as well as in-game peak skating speed was observed. These findings show that strength and jumping performance can be valuable tests within a comprehensive test battery and indicate the relevance of strength and jumping tasks within the regular exercise program to improve in-game skating performance., (Copyright © 2024 National Strength and Conditioning Association.)

Published
2024
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32. Maximum strength and power as determinants of on-ice sprint performance in elite U16 to adult ice hockey players.

Author

Kierot M, Stendahl M, Warneke K, Wirth K, Konrad A, Brauner T, and Keiner M

Abstract

In ice hockey, speed strength is one of the major physical key performance indicators, which is significantly influenced by maximum strength. The objective of this study was to evaluate the age-dependent relationship of off-ice maximum strength and vertical jump performance with on-ice linear sprint performance, considering age and performance level. Ninety-one male youth and adult professional ice hockey players (age: 19.3 ± 5.49 years) were recruited and divided into four age groups: under 16, 18, 21 years old and professional elite players (Pro) (i.e., > 21 years). They were tested in maximal isometric strength, squat jump (loaded and unloaded), countermovement jump and on-ice sprint performance (15 m and 30 m linear sprint; 15 m flying linear sprint). Statistical analysis revealed that on-ice sprint performance correlated with isometric strength performance (r = |0.34|-|0.63|) and with off-ice jump performance (r = |0.61|-|0.77|) without an influence of age group or performance level. However, performance differed between age groups and performance level, the largest differences being found between the youngest age group (U16) and the Pro group (g = 0.966-3.281). The present study shows that maximum strength influences on-ice sprint performances in ice hockey players, as well as performance differences between age groups and professional players. Strength and jumping performance should therefore be included in regular performance testing in ice hockey. Since performance differences are observed for almost all strength and speed-strength performances of the youth teams to the Pros, training of these variables is strongly recommended to improve in the transition phase from junior to elite level., Competing Interests: The authors declare no conflict of interest., (Copyright © Biology of Sport 2024.)

Published
2024
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33. Risk factors for COVID-19 hospitalization and mortality in patients with chronic kidney disease: a nationwide cohort study.

Author

Artborg A, Caldinelli A, Wijkström J, Nowak A, Fored M, Stendahl M, Evans M, and Rydell H

Abstract

Background: Several studies have demonstrated an increased risk of severe coronavirus disease 2019 (COVID-19) in chronic kidney disease (CKD) patients. However, few have investigated the impact of CKD stage and dialysis modality. The primary aim of this study was to investigate the association between CKD stage, dialysis modality and risk of severe COVID-19. Secondly, we aimed to study the impact of comorbidities and drugs on the risk of severe COVID-19 in the CKD population., Methods: This nationwide observational study was based on data from the Swedish Renal Registry and three other national registries. Patients with non-dialysis CKD stage 3b-5 or dialysis on 1 January 2020 were included and followed until 31 December 2021. The primary outcome was COVID-19 hospitalization; the secondary outcome was COVID-19 mortality. Associations were investigated using logistic regression models, adjusting for confounders., Results: The study population comprised 7856 non-dialysis CKD patients and 4018 dialysis patients. The adjusted odds ratios (aOR) for COVID-19 hospitalization and mortality were highest in the dialysis group [aOR 2.24, 95% confidence interval (CI) 1.79-2.81; aOR 3.10, Cl 95% 2.03-4.74], followed by CKD 4 (aOR 1.33, 95% CI 1.05-1.68; aOR 1.66, Cl 95% 1.07-2.57), as compared with CKD 3b. No difference in COVID-19 outcomes was observed between patients on hemodialysis and peritoneal dialysis. Overall comorbidity burden was one of the strongest risk factors for severe COVID-19 and the risk was also increased in patients prescribed insulin, proton pump inhibitors, diuretics, antiplatelets or immunosuppressants., Conclusions: Worsening CKD stage and comorbidity are independent risk factors for severe COVID-19 in the Swedish CKD population., Competing Interests: No potential conflicts of interests relevant to this article were declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)

Published
2023
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34. The ERA Registry Annual Report 2021: a summary.

Author

Boerstra BA, Boenink R, Astley ME, Bonthuis M, Abd ElHafeez S, Arribas Monzón F, Åsberg A, Beckerman P, Bell S, Cases Amenós A, Castro de la Nuez P, Ten Dam MAGJ, Debska-Slizien A, Gjorgjievski N, Giudotti R, Helve J, Hommel K, Idrizi A, Indriðason ÓS, Jarraya F, Kerschbaum J, Komissarov KS, Kozliuk N, Kravljaca M, Lassalle M, De Meester JM, Ots-Rosenberg M, Plummer Z, Radunovic D, Razvazhaieva O, Resic H, Rodríguez Arévalo OL, Santiuste de Pablos C, Seyahi N, Slon-Roblero MF, Stendahl M, Tolaj-Avdiu M, Trujillo-Alemán S, Ziedina I, Ziginskiene E, Ortiz A, Jager KJ, Stel VS, and Kramer A

Abstract

Background: The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with end-stage kidney disease (ESKD). This paper is a summary of the ERA Registry Annual Report 2021, including a comparison across treatment modalities., Methods: Data was collected from 54 national and regional registries from 36 countries, of which 35 registries from 18 countries contributed individual patient data and 19 registries from 19 countries contributed aggregated data. Using this data, incidence and prevalence of KRT, kidney transplantation rates, survival probabilities and expected remaining lifetimes were calculated., Result: In 2021, 533.2 million people in the general population were covered by the ERA Registry. The incidence of KRT was 145 per million population (pmp). In incident patients, 55% were 65 years or older, 64% were male, and the most common primary renal disease (PRD) was diabetes (22%). The prevalence of KRT was 1040 pmp. In prevalent patients, 47% were 65 years or older, 62% were male, and the most common PRDs were diabetes and glomerulonephritis/sclerosis (both 16%). On 31 December 2021, 56% of patients received haemodialysis, 5% received peritoneal dialysis, and 39% were living with a functioning graft. The kidney transplantation rate in 2021 was 37 pmp, a majority coming from deceased donors (66%). For patients initiating KRT between 2012-2016, 5-year survival probability was 52%. Compared to the general population, life expectancy was 65% and 68% shorter for males and females receiving dialysis, and 40% and 43% shorter for males and females living with a functioning graft., Competing Interests: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)

Published
2023
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35. Results of the first nationwide cohort study of outcomes in dialysis and kidney transplant patients before and after vaccination for COVID-19.

Author

Wijkström J, Caldinelli A, Bruchfeld A, Nowak A, Artborg A, Stendahl M, Segelmark M, Lindholm B, Bellocco R, Rydell H, and Evans M

Subjects
Humans, Aged, Middle Aged, Renal Dialysis, Cohort Studies, Pandemics, Kidney Transplantation, COVID-19 epidemiology, COVID-19 prevention & control
Abstract

Background: Patients on kidney replacement therapy (KRT) have been identified as a vulnerable group during the coronavirus disease 2019 (COVID-19) pandemic. This study reports the outcomes of COVID-19 in KRT patients in Sweden, a country where patients on KRT were prioritized early in the vaccination campaign., Methods: Patients on KRT between January 2019 and December 2021 in the Swedish Renal Registry were included. Data were linked to national healthcare registries. The primary outcome was monthly all-cause mortality over 3 years of follow-up. The secondary outcomes were monthly COVID-19-related deaths and hospitalizations. The results were compared with the general population using standardized mortality ratios. The difference in risk for COVID-19-related outcomes between dialysis and kidney transplant recipients (KTRs) was assessed in multivariable logistic regression models before and after vaccinations started., Results: On 1 January 2020, there were 4097 patients on dialysis (median age 70 years) and 5905 KTRs (median age 58 years). Between March 2020 and February 2021, mean all-cause mortality rates increased by 10% (from 720 to 804 deaths) and 22% (from 158 to 206 deaths) in dialysis and KTRs, respectively, compared with the same period in 2019. After vaccinations started, all-cause mortality rates during the third wave (April 2021) returned to pre-COVID-19 mortality rates among dialysis patients, while mortality rates remained increased among transplant recipients. Dialysis patients had a higher risk for COVID-19 hospitalizations and death before vaccinations started {adjusted odds ratio [aOR] 2.1 [95% confidence interval (CI) 1.7-2.5]} but a lower risk after vaccination [aOR 0.5 (95% CI 0.4-0.7)] compared with KTRs., Conclusions: The COVID-19 pandemic in Sweden resulted in increased mortality and hospitalization rates among KRT patients. After vaccinations started, a distinct reduction in hospitalization and mortality rates was observed among dialysis patients, but not in KTRs. Early and prioritized vaccinations of KRT patients in Sweden probably saved many lives., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.)

Published
2023
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36. Increasing numbers and improved overall survival of patients on kidney replacement therapy over the last decade in Europe: an ERA Registry study.

Author

Huijben JA, Kramer A, Kerschbaum J, de Meester J, Collart F, Arévalo OLR, Helve J, Lassalle M, Palsson R, Ten Dam M, Casula A, Methven S, Ortiz A, Ferraro PM, Segelmark M, Mingo PU, Arici M, Reisæter AV, Stendahl M, Stel VS, and Jager KJ

Subjects
Male, Humans, Europe epidemiology, Proportional Hazards Models, Registries, Incidence, Renal Replacement Therapy, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic therapy
Abstract

Background: The aim of this study was to describe the trends in the incidence, prevalence and survival of patients on kidney replacement therapy (KRT) for end-stage kidney disease (ESKD) across Europe from 2008 to 2017., Methods: Data from renal registries in 9 countries and 16 regions that provided individual patient data to the ERA Registry from 2008 to 2017 were included. These registries cover 34% of the general population in Europe. Crude and standardized incidence and prevalence per million population (pmp) were determined. Trends over time were studied using Joinpoint regression. Survival probabilities were estimated using Kaplan-Meier analysis and hazard ratios (HRs) using Cox regression analysis., Results: The standardized incidence of KRT was stable [annual percentage change (APC): -1.48 (-3.15; 0.21)] from 2008 (146.0 pmp) to 2011 (141.6 pmp), followed by a slight increase [APC: 1.01 (0.43; 1.60)] to 148.0 pmp in 2017, although trends in incidence varied across countries. This increase was primarily due to a rise in the incidence of KRT in men older than 65 years. Moreover, as a cause of kidney failure, diabetes mellitus is increasing. The standardized prevalence increased from 2008 (990.0 pmp) to 2017 (1166.8 pmp) [APC: 1.82 (1.75; 1.89)]. Patient survival on KRT improved in the time period 2011-13 compared with 2008-[adjusted HR: 0.94 (0.93; 0.95)]., Conclusion: This study showed an overall increase in the incidence and prevalence of KRT for ESKD as well as an increase in the KRT patient survival over the last decade in Europe., (© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)

Published
2023
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37. Detection of gluten immunogenic peptides and the Celiac Disease Adherence Test to monitor gluten-free diet: a pilot study.

Author

Skodje GI, van Megen F, Stendahl M, Henriksen C, Lundin KEA, and Veierød MB

Subjects
Biomarkers, Female, Glutens, Humans, Patient Compliance, Peptides, Pilot Projects, Celiac Disease, Diet, Gluten-Free
Abstract

Gluten immunogenic peptides (GIP) in feces and/or urine have recently been proposed as a sensitive and specific marker to detect ongoing gluten intake. Here, we compared GIP with the Celiac Disease Adherence Test (CDAT), a simple validated self-administered questionnaire that measures adherence to gluten-free diet (GFD). Of 70 subjects (59 women), six were classified as non-adherent by fecal GIP (mean 0.23 µg/g, standard deviation 0.08, range 0.082-0.319), including five classified as non-adherent by CDAT. GFD adherence was significantly higher by GIP than CDAT (p < 0.001). Fecal GIP may be useful as a biomarker for ongoing gluten intake that is not possible to detect with current clinical methods to assess GFD adherence, and may play a role in the management of persistent gastrointestinal symptoms in celiac disease., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Published
2022
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38. [COVID-19 related mortality in Swedish patients with renal replacement therapy].

Author

Segelmark M, Segelmark L, Smolander J, Rydell H, Evans M, and Stendahl M

Subjects
Humans, Middle Aged, Renal Dialysis, Renal Replacement Therapy, Sweden epidemiology, COVID-19, Kidney Transplantation
Abstract

Data from the Swedish Renal Registry (SRR) show that during the period March 16, 2020 to March 15, 2021 0.4% of all renal transplant recipients and 3% of all dialysis patients died due to COVID-19 in Sweden. Of all registered deaths, 20% were attributed to COVID-19.  In the age group 50-59 years the risk ratio for COVID-19 related mortality was 16 (95% CI 6.5-38) among transplant recipients and 22 (95% CI 7.1-69) among dialysis patients, compared to the background population in the same age group. Excess mortality, compared to the five years preceding the pandemic, was 30% for transplant recipients and 8.7% for dialysis patients, compared to 7.7% for the entire Swedish population. Detailed reports were sent to SRR for 864 patients with confirmed COVID-19 infection representing 5.0% of all transplant recipients and 13% of all dialysis patients. The case fatality rate was 7.0% and 21% respectively.

Published
2021

39. High disease burden in treated celiac patients - a web-based survey.

Author

van Megen F, Skodje GI, Stendahl M, Veierød MB, Lundin KEA, and Henriksen C

Subjects
Adult, Cost of Illness, Cross-Sectional Studies, Diet, Gluten-Free, Female, Humans, Internet, Male, Middle Aged, Quality of Life, Celiac Disease epidemiology, Irritable Bowel Syndrome epidemiology
Abstract

Background: Strict adherence to a gluten-free diet usually leads to clinical and histological remission in celiac disease. Few studies have investigated the prevalence of persistent symptoms in a celiac population. We aimed to study the impact of gastrointestinal symptoms on general health in a large number of treated celiac patients, and describe the prevalence of persistent gastrointestinal symptoms and investigate associated factors., Methods: Adults with celiac disease filled out background questions, the Celiac Symptom Index (CSI) and the celiac disease adherence test (CDAT) in a web-based national survey. Participants who reported gastrointestinal symptoms during the previous week also recorded the gastrointestinal symptom rating scale-irritable bowel syndrome version (GSRS-IBS). Statistical analysis included chi-squared test, t -test, correlation, and linear regression., Results: Of 3834 participants (82% women; mean age 47 years), 54% reported gastrointestinal symptoms the previous week, and 30% of these had CSI score ≥45, indicative of the relatively poor quality of life (vs. 5% among those without gastrointestinal symptoms). The prevalence of persistent gastrointestinal symptoms (GSRS-IBS ≥30) was 40% and the most prominent symptoms were bloating (44%) and pain (37%). Age, sex, symptoms at the time of diagnosis, comorbidity, dietary adherence and CeD-specific health were significantly associated with gastrointestinal symptoms ( p  < .001)., Conclusion: In this national cross-sectional study among participants with celiac disease, persistent gastrointestinal symptoms were frequent, and were associated with a high symptom burden and reduced CeD-specific health. Several factors were associated with gastrointestinal symptoms, but more research is needed to find the cause of persistent symptoms in patients with celiac disease.

Published
2021
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40. CKD Progression and Mortality Among Men and Women: A Nationwide Study in Sweden.

Author

Swartling O, Rydell H, Stendahl M, Segelmark M, Trolle Lagerros Y, and Evans M

Subjects
Age Factors, Aged, Aged, 80 and over, Albuminuria metabolism, Cardiovascular Diseases mortality, Cause of Death, Cohort Studies, Disease Progression, Female, Humans, Linear Models, Male, Middle Aged, Proportional Hazards Models, Renal Insufficiency, Chronic physiopathology, Renal Insufficiency, Chronic therapy, Renal Replacement Therapy, Risk Factors, Severity of Illness Index, Sex Factors, Sweden, Glomerular Filtration Rate, Mortality, Renal Insufficiency, Chronic metabolism
Abstract

Rationale & Objective: Chronic kidney disease (CKD) is a global health problem with increasing prevalence. Several sex-specific differences have been reported for disease progression and mortality. Selection and survival bias might have influenced the results of previous cohort studies. The objective of this study was to investigate sex-specific differences of CKD progression and mortality among patients with CKD not receiving maintenance dialysis., Study Design: Observational cohort study., Setting & Participants: Adult patients with incident CKD glomerular filtration rate categories 3b to 5 (G3b-G5) identified between 2010 and 2018 within the nationwide Swedish Renal Registry-CKD (SRR-CKD)., Exposure: Sex., Outcomes: Time to CKD progression (defined as a change of at least 1 CKD stage or initiation of kidney replacement therapy [KRT]) or death. Repeated assessments of estimated glomerular filtration rate (eGFR)., Analytical Approach: CKD progression and mortality before KRT were assessed by the cumulative incidence function methods and Fine and Gray models, with death handled as a competing event. Sex differences in eGFR slope were estimated using mixed effects linear regression models., Results: 7,388 patients with incident CKD G3b, 18,282 with incident CKD G4, and 9,410 with incident CKD G5 were identified. Overall, 19.6 (95% CI, 19.2-20.0) patients per 100 patient-years progressed, and 10.1 (95% CI, 9.9-10.3) patients per 100 person-years died. Women had a lower risk of CKD progression (subhazard ratio [SHR], 0.88 [95% CI, 0.85-0.92]), and a lower all-cause (SHR, 0.90 [95% CI, 0.85-0.94]) and cardiovascular (SHR, 0.83 [95% CI, 0.76-0.90]) mortality risk. Risk factors related to a steeper decline in eGFR included age, sex, albuminuria, and type of primary kidney disease., Limitations: Incomplete data for outpatient visits and laboratory measurements and regional differences in reporting., Conclusions: Compared to women, men had a higher rate of all-cause and cardiovascular mortality, an increased risk of CKD progression, and a steeper decline in eGFR., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2021
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41. Treatment practices and outcomes in incident peritoneal dialysis patients: the Swedish Renal Registry 2006-2015.

Author

Xu H, Lindholm B, Lundström UH, Heimbürger O, Stendahl M, Rydell H, Segelmark M, Carrero JJ, and Evans M

Abstract

Background: Therapeutic developments have contributed to markedly improved clinical outcomes in peritoneal dialysis (PD) during the 1990s and 2000s. We investigated whether recent advances in PD treatment are implemented in routine Swedish care and whether their implementation parallels improved patient outcomes., Methods: We conducted an observational study of 3122 patients initiating PD in Sweden from 2006 to 2015. We evaluated trends of treatment practices (medications, PD-related procedures) and outcomes [patient survival, major adverse cardiovascular events (MACEs), peritonitis, transfer to haemodialysis (HD) and kidney transplantation] and analysed associations of changes of treatment practices with changes in outcomes., Results: Over the 10-year period, demographics (mean age 63 years, 33% women) and comorbidities remained essentially stable. There were changes in clinical characteristics (body mass index and diastolic blood pressure increased), prescribed drugs (calcium channel blockers, non-calcium phosphate binders and cinacalcet increased and the use of renin-angiotensin system inhibitors, erythropoietin and iron decreased) and dialysis treatment (increased use of automated PD, icodextrin and assisted PD). The standardized 1- and 2-year mortality and MACE risk did not change over the period. Compared with the general population, the risk of 1-year mortality was 4.1 times higher in 2006-2007 and remained stable throughout follow-up. However, the standardized 1- and 2-year peritonitis rate decreased and the incidence of kidney transplantation increased while transfers to HD did not change., Conclusions: Over the last decade, treatment advances in PD patients were accompanied by a substantial decline in peritonitis frequency and an increased rate of kidney transplantations, while 1- and 2-year survival and MACE risk did not change., (© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2021
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42. Increased risk for renal cell carcinoma in end stage renal disease - a population-based case-control study.

Author

Åkerlund J, Holmberg E, Lindblad P, Stendahl M, Ljungberg B, Thorstenson A, and Lundstam S

Subjects
Case-Control Studies, Humans, Renal Dialysis, Carcinoma, Renal Cell epidemiology, Kidney Failure, Chronic epidemiology, Kidney Neoplasms epidemiology
Abstract

Purpose: End-stage renal disease (ESRD) is a known risk factor for the development of renal cell carcinoma (RCC). This case-control study was performed to assess the risk in a nationwide cohort and evaluate tumor characteristics and survival in the ESRD-RCC population., Methods: In this study, 9,299 patients with RCC identified in the National Swedish Kidney Cancer Register from 2005 until 2014 and 93,895 matched controls were linked to the Swedish Renal Registry and the National Patient Register. ESRD was defined as chronic kidney disease stage 5, kidney transplantation or kidney dialysis 0-40 years before the diagnosis of RCC., Results: A total of 117 patients with ESRD and subsequent RCC were identified and compared with 9,087 patients with RCC. There was a 4.5-times increased risk for RCC among ESRD patients (95% CI = 3.6-5.6; p  < 0.001) compared to matched controls. Longer time with ESRD increased the risk of RCC (ESRD > 9 years, OR = 10.2, 95% CI = 7.0-14.8). The ESRD-RCC patients were younger ( p  = 0.002), had smaller tumors ( p  < 0.001) and had lower tumor stage ( p  = 0.045). The incidence of papillary and chromophobe RCC was higher and clear cell RCC lower among the ESRD patients ( p  < 0.001). The 5-year overall survival was 50% in ESRD-RCC patients and 63% in RCC-only patients ( p  < 0.05)., Conclusion: More than 9 years with ESRD increased the risk of developing RCC 10-times compared to individuals without ESRD and the tumors showed a different histopathological pattern. Despite a less advanced tumor stage at diagnosis, the overall survival in ESRD-RCC patients was lower compared to patients with RCC-only.

Published
2021
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43. The ERA-EDTA Registry Annual Report 2018: a summary.

Author

Kramer A, Boenink R, Stel VS, Santiuste de Pablos C, Tomović F, Golan E, Kerschbaum J, Seyahi N, Ioanou K, Beltrán P, Zurriaga O, Magaz Á, Slon Roblero MF, Gjorgjievski N, Garneata L, Arribas F, Galvão AA, Bell S, Ots-Rosenberg M, Muñoz-Terol JM, Winzeler R, Hommel K, Åsberg A, Spustova V, Palencia García MÁ, Vazelov E, Finne P, Ten Dam MAGJ, Lopot F, Trujillo-Alemán S, Lassalle M, Kolesnyk MO, Santhakumaran S, Idrizi A, Andrusev A, Comas Farnés J, Komissarov K, Resić H, Palsson R, Kuzema V, Garcia Bazaga MA, Ziginskiene E, Stendahl M, Bonthuis M, Massy ZA, and Jager KJ

Abstract

Background: The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry collects data on kidney replacement therapy (KRT) via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article summarizes the 2018 ERA-EDTA Registry Annual Report, and describes the epidemiology of KRT for kidney failure in 34 countries., Methods: Individual patient data on patients undergoing KRT in 2018 were provided by 34 national or regional renal registries and aggregated data by 17 registries. The incidence and prevalence of KRT, the kidney transplantation activity and the survival probabilities of these patients were calculated., Results: In 2018, the ERA-EDTA Registry covered a general population of 636 million people. Overall, the incidence of KRT for kidney failure was 129 per million population (p.m.p.), 62% of patients were men, 51% were ≥65 years of age and 20% had diabetes mellitus as cause of kidney failure. Treatment modality at the onset of KRT was haemodialysis (HD) for 84%, peritoneal dialysis (PD) for 11% and pre-emptive kidney transplantation for 5% of patients. On 31 December 2018, the prevalence of KRT was 897 p.m.p., with 57% of patients on HD, 5% on PD and 38% living with a kidney transplant. The transplant rate in 2018 was 35 p.m.p.: 68% received a kidney from a deceased donor, 30% from a living donor and for 2% the donor source was unknown. For patients commencing dialysis during 2009-13, the unadjusted 5-year survival probability was 42.6%. For patients receiving a kidney transplant within this period, the unadjusted 5-year survival probability was 86.6% for recipients of deceased donor grafts and 93.9% for recipients of living donor grafts., (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2020
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44. Association Between Implementation Of Novel Therapies And Improved Survival In Patients Starting Hemodialysis: The Swedish Renal Registry 2006-2015.

Author

Evans M, Xu H, Rydell H, Prütz KG, Lindholm B, Stendahl M, Segelmark M, and Carrero JJ

Abstract

Background: The recent years have witnessed significant therapeutic advances for patients on hemodialysis. We evaluated temporal changes in treatments practices and survival rates among incident hemodialysis patients., Methods: Observational study of patients initiating hemodialysis in Sweden 2006-2015. Trends of hemodialysis-related practices, medications, and routine laboratory biomarkers were evaluated. The incidence of death and major cardiovascular events (MACE) across calendar years were compared against the age-sex-matched general population. Via Cox regression, we explored whether adjustment for implementation of therapeutic advances modified observed survival and MACE risks., Results: Among 6,612 patients, age and sex were similar, but the burden of co-morbidities increased over time. The proportion of patients receiving treatment by hemodiafiltration, >3 sessions/week, lower ultrafiltration rate, and working fistulas increased progressively, as did use of non-calcium phosphate binders, cinacalcet, and vitamin D3. The standardized 1-year mortality decreased from 13.2% in 2006/07 to 11.1% in 2014/15. The risk of death decreased by 6% (HR 0.94, 95% CI 0.90-0.99) every two years, and the risk of MACE by 4% (HR 0.96; 0.92-1.00). Adjustment for changes in treatment characteristics abrogated these associations (HR 1.00; 0.92-1.09 for death and 1.00; 0.94-1.06 for MACE). Compared with the general population, the risk of death declined from 6 times higher 2006/2007 [standardized incidence rate ratio, sIRR 6.0 (5.3-6.9)], to 5.6 higher 2014/15 [sIRR 5.57 (4.8-6.4)]., Conclusions: Gradual implementation of therapeutic advances over the last decade was associated with a parallel reduction in short-term risk of death and MACE among hemodialysis patients., (© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2020
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45. Patient-reported outcome measures as a new application in the Swedish Renal Registry: health-related quality of life through RAND-36.

Author

Pagels AA, Stendahl M, and Evans M

Abstract

Background: Although patient-reported outcome measures (PROMs) are gaining increased interest in developing health care quality and are a useful tool in person-centered care, their use in routine care is still limited. The aim of this study is to describe the implementation and initial results of PROMs via the Swedish Renal Registry (SRR) on a national level., Methods: After testing and piloting the electronic PROM application, nationwide measures were carried out in 2017 for completing the RAND-36 questionnaire online or by paper in a wide range of chronic kidney disease (CKD) patients (Stages 3-5, dialysis and transplantation) through the SRR. Cross-sectional results during the first year were analyzed by descriptive statistics and stratified by treatment modality., Results: A total of 1378 patients from 26 of 68 renal units (39%) completed the questionnaire. The response rate for all participating hemodialysis units was 38.9%. The CKD patients had an impaired health profile compared with a Swedish general population, especially regarding physical functions and assessed general health (GH). Transplanted patients had the highest scores, whereas patients on dialysis treatment had the lowest scores. The youngest age group assessed their physical function higher and experienced fewer physical limitations and less bodily pain than the other age groups but assessed their GH and vitality (VT) relatively low. The oldest age group demonstrated the lowest health profile but rated their mental health higher than the other age groups. The older the patient, the smaller the difference compared with persons of the same age in the general population., Conclusions: Nationwide, routine collection of PROMs is feasible in Sweden. However, greater emphasis is needed on motivating clinical staff to embrace the tool and its possibilities in executing person-centered care. CKD patients demonstrate impaired health-related quality of life, especially regarding limitations related to physical problems, GH and VT/energy/fatigue., (© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.)

Published
2019
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46. Renal replacement therapy in Europe: a summary of the 2013 ERA-EDTA Registry Annual Report with a focus on diabetes mellitus.

Author

Kramer A, Pippias M, Stel VS, Bonthuis M, Abad Diez JM, Afentakis N, Alonso de la Torre R, Ambuhl P, Bikbov B, Bouzas Caamaño E, Bubic I, Buturovic-Ponikvar J, Caskey FJ, Castro de la Nuez P, Cernevskis H, Collart F, Comas Farnés J, Garcia Bazaga Mde L, De Meester J, Ferrer Alamar M, Finne P, Garneata L, Golan E, G Heaf J, Hemmelder M, Ioannou K, Kantaria N, Kolesnyk M, Kramar R, Lassalle M, Lezaic V, Lopot F, Macário F, Magaz A, Martín-Escobar E, Metcalfe W, Ots-Rosenberg M, Palsson R, Piñera Celestino C, Resić H, Rutkowski B, Santiuste de Pablos C, Spustová V, Stendahl M, Strakosha A, Süleymanlar G, Torres Guinea M, Varberg Reisæter A, Vazelov E, Ziginskiene E, Massy ZA, Wanner C, Jager KJ, and Noordzij M

Abstract

Background: This article provides a summary of the 2013 European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report (available at http://www.era-edta-reg.org), with a focus on patients with diabetes mellitus (DM) as the cause of end-stage renal disease (ESRD)., Methods: In 2015, the ERA-EDTA Registry received data on renal replacement therapy (RRT) for ESRD from 49 national or regional renal registries in 34 countries in Europe and bordering the Mediterranean Sea. Individual patient data were provided by 31 registries, while 18 registries provided aggregated data. The total population covered by the participating registries comprised 650 million people., Results: In total, 72 933 patients started RRT for ESRD within the countries and regions reporting to the ERA-EDTA Registry, resulting in an overall incidence of 112 per million population (pmp). The overall prevalence on 31 December 2013 was 738 pmp (n = 478 990). Patients with DM as the cause of ESRD comprised 24% of the incident RRT patients (26 pmp) and 17% of the prevalent RRT patients (122 pmp). When compared with the USA, the incidence of patients starting RRT pmp secondary to DM in Europe was five times lower and the incidence of RRT due to other causes of ESRD was two times lower. Overall, 19 426 kidney transplants were performed (30 pmp). The 5-year adjusted survival for all RRT patients was 60.9% [95% confidence interval (CI) 60.5-61.3] and 50.6% (95% CI 49.9-51.2) for patients with DM as the cause of ESRD.

Published
2016
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47. Glomerular filtration rate-estimating equations for patients with advanced chronic kidney disease.

Author

Evans M, van Stralen KJ, Schön S, Prütz KG, Stendahl M, Rippe B, and Jager KJ

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Young Adult, Data Interpretation, Statistical, Glomerular Filtration Rate, Kidney Failure, Chronic physiopathology
Abstract

Background: Renal function is often estimated using one of several glomerular filtration rate (GFR) estimating equations. However, there is no consensus which estimating equation performs best in patients with advanced renal failure., Methods: We compared the performance of five different estimated GFR (eGFR) equations [Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease (CKD) Epidemiology collaboration (CKD-EPI) and Mayo Clinic and Lund-Malmö] with measured GFR (plasma iohexol clearance) in 2098 referred CKD patients with mGFR <30 mL/min/1.73 m(2)., Results: There were 398 patients with an mGFR ≤ 10 mL/min/1.73 m(2), 1974 with a measured GFR (mGFR) 11-20 mL/min/1.73 m(2) and 749 patients with mGFR 21-30 mL/min/1.73 m(2). Across the entire range, the median bias of eGFR was lowest for the Lund-Malmö equation (0.7 mL/min/1.73 m(2)), followed by the CKD-EPI (1.2 mL/min/1.73 m(2)), the MDRD (1.6 mL/min/1.73 m(2)), Mayo Clinic equation (1.7 mL/min/1.73 m(2)) and Cockcroft-Gault equation (4.6 mL/min/1.73 m(2)). The best accuracy within 30% of mGFR was also for Lund-Malmö (76%), while it was similar for CKD-EPI, MDRD and Mayo (65-67%). The Cockcroft-Gault had the worst accuracy of only ∼54%.The median bias was stable across mGFR categories, while the accuracy within 30% of mGFR became worse with decreasing mGFR. All equations performed best among patients with hereditary kidney diseases and tubulointerstitial disease. Accuracy was generally worse for patients >65 years of age and for those with diabetic nephropathy., Conclusions: In patients with advanced renal failure, the GFR-estimating equations show reasonably good performance on the population level. On the individual patient level, they are inaccurate, especially in elderly patients and those with diabetic nephropathy.

Published
2013
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48. p27Kip1 is a predictive factor for tamoxifen treatment response but not a prognostic marker in premenopausal breast cancer patients.

Author

Stendahl M, Nilsson S, Wigerup C, Jirström K, Jönsson PE, Stål O, and Landberg G

Subjects
Adult, Breast Neoplasms pathology, Cyclin-Dependent Kinase Inhibitor p27, Female, Humans, Immunoenzyme Techniques, Middle Aged, Receptors, Estrogen metabolism, Survival Rate, Treatment Outcome, Antineoplastic Agents, Hormonal therapeutic use, Biomarkers, Tumor metabolism, Breast Neoplasms drug therapy, Breast Neoplasms metabolism, Intracellular Signaling Peptides and Proteins metabolism, Premenopause, Tamoxifen therapeutic use
Abstract

The cell-cycle regulating protein p27(Kip1) (p27) has dual roles by acting as both a cdk inhibitor and as an assembly factor for different cdk complexes. Loss of p27 has been linked to malignant features in tumours; however, the exact role of p27 deregulation in breast cancer regarding prognostic and treatment predictive information has not been fully clarified. We have evaluated p27 expression in 328 primary, Stage II breast cancers from premenopausal patients who had been randomised to either tamoxifen treatment or no adjuvant treatment after surgery. p27 was associated with the oestrogen receptor and cyclin D1, and p27 downregulation was associated with high proliferation. There was no association between recurrence-free survival (RFS) and p27 (HR = 0.800, 95% CI 0.523-1.222, p = 0.300), indicating that p27 is not a prognostic marker. The predictive value of p27 was analysed by comparing RFS in tamoxifen-treated and untreated patients in subgroups of low and high p27 expression (HR = 0.747, 95% CI 0.335-1.664, p = 0.474 and HR = 0.401, 95% CI 0.240-0.670, p < 0.001, respectively). Only patients with p27-high tumours benefited from tamoxifen (multivariate interaction analysis p = 0.034). Our study suggests that p27 downregulation is associated with tamoxifen resistance in premenopausal breast cancer but is not linked to impaired prognosis., (Copyright © 2010 UICC.)

Published
2010
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49. Oestrogen receptors alpha and beta show different associations to clinicopathological parameters and their co-expression might predict a better response to endocrine treatment in breast cancer.

Author

Borgquist S, Holm C, Stendahl M, Anagnostaki L, Landberg G, and Jirström K

Subjects
Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Hormonal therapeutic use, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Female, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Proteins metabolism, Prognosis, Survival Analysis, Tissue Array Analysis methods, Treatment Outcome, Biomarkers, Tumor metabolism, Breast Neoplasms metabolism, Estrogen Receptor alpha metabolism, Estrogen Receptor beta metabolism
Abstract

Aims: The majority of all breast cancers are hormone responsive, traditionally defined by the expression of oestrogen receptor (ER) alpha and/or progesterone receptors. In contrast to ERalpha, the clinical significance of the relatively recently identified ERbeta is still unclear. This study aimed to define the relationship between ERbeta and clinicopathological parameters in a mixed cohort of breast cancer and, furthermore, to investigate the impact of ERbeta expression on disease outcome., Methods: The immunohistochemical expression of ERalpha and ERbeta was analysed in tissue microarrays containing a total number of 512 tumours with all incident breast cancers diagnosed at the Malmö University Hospital between 1988 and 1992., Results: 78% of the tumours were ERalpha positive and 50% were ERbeta positive. ERbeta correlated positively with ERalpha (p = 0.001). In contrast to ERalpha, ERbeta was not associated with any important clinicopathological variables. Furthermore, no overall prognostic significance could be demonstrated for ERbeta. In the ERalpha-positive subgroup, however, a low expression of ERbeta correlated with a decreased disease-free survival in patients receiving endocrine treatment (p = 0.003)., Conclusions: Although interrelated, ERalpha and ERbeta seem to be differentially associated to clinicopathological parameters, and this would support the fact that they might have different functions in vivo. Furthermore, ERbeta might be a predictive marker of response to endocrine therapy, although this needs to be confirmed in additional studies, preferably randomised trials.

Published
2008
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50. High progesterone receptor expression correlates to the effect of adjuvant tamoxifen in premenopausal breast cancer patients.

Author

Stendahl M, Rydén L, Nordenskjöld B, Jönsson PE, Landberg G, and Jirström K

Subjects
Breast Neoplasms diagnosis, Chemotherapy, Adjuvant, Disease-Free Survival, Female, Follow-Up Studies, Humans, Immunohistochemistry, Predictive Value of Tests, Premenopause, Randomized Controlled Trials as Topic, Receptors, Estrogen biosynthesis, Survival Rate, Tissue Array Analysis, Treatment Outcome, Antineoplastic Agents therapeutic use, Breast Neoplasms drug therapy, Receptors, Progesterone biosynthesis, Tamoxifen therapeutic use
Abstract

Purpose: Tamoxifen has long been the drug of choice in adjuvant endocrine therapy of steroid hormone receptor-positive breast cancer, and it still remains important due to its well-documented beneficial effect. Hormone receptor status is often reported as "positive" or "negative" using 10% positive nuclei as a cutoff. In this study, we aimed to assess whether a further subclassification of hormone receptor status could enhance the treatment predictive value., Experimental Design: The immunohistochemical expression of estrogen receptor (ER) and progesterone receptor (PR) was quantified in tissue microarrays with tumors from 500 premenopausal breast cancer patients previously included in a randomized trial of adjuvant tamoxifen compared with an untreated control group., Results: Our findings show a gradually increasing tamoxifen effect in tumors with >10% ER-positive nuclei. However, when analyzing tamoxifen response according to various PR fractions, we found that it was primarily patients with tumors showing >75% PR-positive nuclei that responded to tamoxifen treatment, with an improved recurrence-free [relative risk, 0.42 (0.25-0.70); P = 0.001] as well as overall [relative risk, 0.49 (0.28-0.84); P = 0.010] survival., Conclusions: Adjuvant tamoxifen improved recurrence-free and overall survival for premenopausal patients with tumors showing >75% PR-positive nuclei. No effect could be shown in tumors with fewer PR-positive nuclei. The PR was a stronger predictor of treatment response than the ER. Based on these findings, we suggest the implementation of a fractioned rather than dichotomized immunohistochemical evaluation of hormone receptors in clinical practice, possibly with greater emphasis on the PR than the ER.

Published
2006
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