| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Barany, E, et al.
(författare)
-
Mercury and selenium in whole blood and serum in relation to fish consumption and amalgam fillings in adolescents
- 2003
-
Ingår i: Journal of Trace Elements in Medicine and Biology. - 1878-3252 .- 0946-672X. ; 17:3, s. 165-170
-
Tidskriftsartikel (refereegranskat)abstract
- Mercury and selenium in whole blood and serum of 245 17-year old Swedish adolescents were analysed. The relationships between these elements' concentrations and the consumption of fish as well as the number of dental amalgam fillings were studied. The geometric means (GM) of the mercury concentrations were 1.1 mug/L in blood and 0.43 mug/L in serum. The mean selenium concentration in blood was 110 mug/L and the GM of the serum selenium concentration 110 mug/L. Fish species with dietary restrictions due to elevated mercury Levels (i.e. pike, perch, pikeperch, burbot, eel and halibut) were consumed on average 0.7 times/month and fish species without such restrictions 4.1 times/month. Despite this comparatively Low fish consumption, the adolescents' blood mercury concentrations were positively correlated with fish consumption. Of the adolescents, 39% had amalgam fillings (mean 2 +/- 1.5). Serum mercury was influenced by the number of amalgam fittings, by fish consumption, blood and serum levels of selenium and the residential area. Blood and serum selenium concentrations were not influenced by fish consumption, but were positively associated with the serum mercury concentration.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Barany, E, et al.
(författare)
-
Relationships between trace element concentrations in human blood and serum
- 2002
-
Ingår i: Toxicology Letters. - 1879-3169 .- 0378-4274. ; 134:1-3, s. 177-184
-
Tidskriftsartikel (refereegranskat)abstract
- Trace element interactions can affect the absorption, metabolism, or effects of elements. Also, different elements may derive from the same source. Associations in biological media between element concentrations may indicate such phenomena. A large number of correlations were found between 13 trace elements (Co, Cu, Zn, Se, Rb, Rh, Pd, Cd, W, Pt, Hg, Tl, and Pb) in human blood and/or serum, as investigated in 372 Swedish adolescents. Notably, serum Se correlated with blood Ph and blood Hg and Cu and Zn were correlated to each other in both blood and serum. The elements Pt, Pd and Rh, spread in the environment through use of catalytic converters in cars, were closely correlated in both blood and serum. Apart from the correlations with a probable biological or exposure-related explanation, several other correlations, of yet unknown importance and origin, were found.
|
|
| 12. |
- Barany, E, et al.
(författare)
-
Trace element levels in whole blood and serum from Swedish adolescents
- 2002
-
Ingår i: Science of the Total Environment. - 1879-1026 .- 0048-9697. ; 286:1-3, s. 129-141
-
Tidskriftsartikel (refereegranskat)abstract
- Blood and serum samples from 372 15-year-old adolescents were collected in two cities in Sweden and analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The objective was to (1) determine the levels of 13 elements in blood and serum from the teenagers; and (2) for each element, investigate the correlation between the concentrations in blood and serum. The concentrations in blood and serum were generally in line with that usually reported for the essential elements Co, Cu, Zn and Se, and generally low for the 'non-essential' elements Cd, Hg, Pb. The median concentrations were in blood and serum, respectively: of Co 031 and 0.48 mug/l, Cu 0.92 and 1.0 mg/l, Zn 6.1 and 0.99 mg/l, Se 110 and 100 mug/l, Rb 2.8 and 0.24 mg/l, Hg 1.1 and 0.44 mug/l, Pb 16 and 0.33 mug/l. The median concentration of W in blood was < 0.2 mug/l (below the detection limit) and in serum 0.087 mug/l. The median concentrations of Cd, Rh, Pd, Pt and TI were below the detection limits. Statistically significant correlations were found between the concentrations in blood and serum for Co, Cu, Zn, Se, Rb, W, Hg and Pb. The levels presented in this study constitute baseline levels or levels generally not exceeded in adolescents for 13 elements, including essential, ubiquitous toxic, and rare elements.
|
|
| 13. |
- Barany, E, et al.
(författare)
-
Trace elements in blood and serum of Swedish adolescents: Relation to gender, age, residential area, and socioeconomic status
- 2002
-
Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 89:1, s. 72-84
-
Tidskriftsartikel (refereegranskat)abstract
- The influence of gender, age, residential area, and socioeconomic status on the blood and serum levels of 13 trace elements was studied in boys and girls living in two Swedish cities with different socioeconomic and environmental characters. The same groups of adolescents were sampled twice, at ages 15 (n = 372) and 17 (n = 294) years. All the investigated factors were shown to be of importance. Age was important for most elements; e.g., copper levels in both blood and serum increased in girls, and selenium increased in serum from both genders. Lead decreased approximately 10%, in blood from the first to the second sampling, and cadmium increased in blood, however not in nonsmokers. The age factor may also reflect temporal changes in environmental exposure, especially for nonessential elements. Girls had higher levels of cobalt and copper, while lead in blood was higher in boys. Smoking girls had higher copper levels than nonsmoking girls. Residential area influenced all elements. The teenagers with university-educated mothers had higher levels of cadmium in blood than those with only primary school-educated mothers.
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
- Bosi, Alessandro, et al.
(författare)
-
Use of nephrotoxic medications in adults with chronic kidney disease in Swedish and US routine care
- 2022
-
Ingår i: Clinical Kidney Journal. - : Oxford University Press (OUP). - 2048-8505 .- 2048-8513. ; 15:3, s. 442-451
-
Tidskriftsartikel (refereegranskat)abstract
- Background: To characterize the use of nephrotoxic medications in patients with chronic kidney disease (CKD) Stages G3-5 in routine care.Methods: We studied cohorts of adults with confirmed CKD G3-5 undergoing routine care from 1 January 2016 through 31 December 2018 in two health systems [Stockholm CREAtinine Measurements (SCREAM), Stockholm, Sweden (N = 57 880) and Geisinger, PA, USA (N = 16 255)]. We evaluated the proportion of patients receiving nephrotoxic medications within 1 year overall and by baseline kidney function, ranked main contributors and examined the association between receipt of nephrotoxic medication and age, sex, CKD G-stages comorbidities and provider awareness of the patient's CKD using multivariable logistic regression.Results: During a 1-year period, 20% (SCREAM) and 17% (Geisinger) of patients with CKD received at least one nephrotoxic medication. Among the top nephrotoxic medications identified in both cohorts were non-steroidal anti-inflammatory drugs (given to 11% and 9% of patients in SCREAM and Geisinger, respectively), antivirals (2.5% and 2.0%) and immunosuppressants (2.7% and 1.5%). Bisphosphonate use was common in SCREAM (3.3%) and fenofibrates in Geisinger (3.6%). Patients <65 years of age, women and those with CKD G3 were at higher risk of receiving nephrotoxic medications in both cohorts. Notably, provider awareness of a patient's CKD was associated with lower odds of nephrotoxic medication use {odds ratios [OR] 0.85[95% confidence interval (CI) 0.80-0.90] in SCREAM and OR 0.80 [95% CI 0.72-0.89] in Geisinger}.Conclusions: One in five patients with CKD received nephrotoxic medications in two distinct health systems. Strategies to increase physician's awareness of patients' CKD and knowledge of drug nephrotoxicity may reduce prescribing nephrotoxic medications and prevent iatrogenic kidney injury.
|
|
| 17. |
- Carlström, Mattias, et al.
(författare)
-
Peritoneal dialysis impairs nitric oxide homeostasis and may predispose infants with low systolic blood pressure to cerebral ischemia
- 2016
-
Ingår i: Nitric Oxide - Biology and Chemistry. - : Elsevier BV. - 1089-8603 .- 1089-8611. ; 58, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Background & purpose Infants on chronic peritoneal dialysis (PD) have an increased risk of developing neurological morbidities; however, the underlying biological mechanisms are poorly understood. In this clinical study, we investigated whether PD-mediated impairment of nitric oxide (NO) bioavailability and signaling, in patients with persistently low systolic blood pressure (SBP), can explain the occurrence of cerebral ischemia. Methods & results Repeated blood pressure measurements, serial neuroimaging studies, and investigations of systemic nitrate and nitrite levels, as well as NO signaling, were performed in ten pediatric patients on PD. We consistently observed the loss of both inorganic nitrate (-17 ± 3%, P < 0.05) and nitrite (-34 ± 4%, P < 0.05) during PD, which may result in impairment of the nitrate-nitrite-NO pathway. Indeed, PD was associated with significant reduction of cyclic guanosine monophosphate levels (-59.4 ± 15%, P < 0.05). This reduction in NO signaling was partly prevented by using a commercially available PD solution supplemented with l-arginine. Although PD compromised nitrate-nitrite-NO signaling in all cases, only infants with persistently low SBP developed ischemic cerebral complications. Conclusions Our data suggests that PD impairs NO homeostasis and predisposes infants with persistently low SBP to cerebral ischemia. These findings improve current understanding of the pathogenesis of infantile cerebral ischemia induced by PD and may lead to the new treatment strategies to reduce neurological morbidities.
|
|
| 18. |
- Carrero, Juan Jesus, et al.
(författare)
-
Albuminuria changes are associated with subsequent risk of end-stage renal disease and mortality
- 2017
-
Ingår i: Kidney International. - : Elsevier BV. - 0085-2538 .- 1523-1755. ; 91:1, s. 244-251
-
Tidskriftsartikel (refereegranskat)abstract
- Current guidelines for chronic kidney disease (CKD) recommend using albuminuria as well as estimated glomerular filtration rate (eGFR) to stage CKD. However, CKD progression is solely defined by change in eGFR with little regard to the risk implications of change in albuminuria. This is an observational study from the Stockholm CREAtinine Measurements (SCREAM) project, a health care utilization cohort from Stockholm, Sweden, with laboratory measures from 2006-2011 and follow-up through December 2012. Included were 31,732 individuals with two or more ambulatory urine albumin to creatinine ratio (ACR) tests. We assessed the association between change in ACR during a baseline period of 1, 2, or 3 years and end-stage renal disease (ESRD) or death. Using a 2-year baseline period, there were 378 ESRD events and 1712 deaths during a median of 3 years of follow-up. Compared to stable ACR, a 4-fold increase in ACR was associated with a 3.08-times (95% confidence interval 2.59 to 3.67) higher risk of ESRD while a 4-fold decrease in ACR was associated with a 0.34-times (0.26 to 0.45) lower risk of ESRD. Similar associations were found in people with and without diabetes mellitus, with and without hypertension, and also when adjusted for the change in eGFR during the same period. The association between change in ACR and mortality was weaker: ACR increase was associated with mortality, but the relationship was largely flat for ACR decline. Results were consistent for 1-, 2-, and 3-year ACR changes. Thus, changes in albuminuria are strongly and consistently associated with the risk of ESRD and death.
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
- Evans, M, et al.
(författare)
-
Contemporary management of anaemia, erythropoietin resistance and cardiovascular risk in patients with advanced chronic kidney disease: a nationwide analysis
- 2020
-
Ingår i: Clinical kidney journal. - : Oxford University Press (OUP). - 2048-8505 .- 2048-8513. ; 13:5, s. 821-827
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundOptimal management of chronic kidney disease (CKD) anaemia remains controversial and few studies have evaluated real-world management of anaemia in advanced CKD in the context of guideline recommendations.MethodsWe performed an observational study from the Swedish Renal Registry evaluating the epidemiology and treatment patterns of anaemia across Stages 3b–5 in non-dialysis (ND) and dialysis-dependent (DD) CKD patients during 2015. Logistic regression and Cox models explored the associations between anaemia treatments, inflammation, erythropoietin resistance index (ERI) and subsequent 1-year risk of major adverse cardiovascular events (MACEs).ResultsData from 14 415 (ND, 11 370; DD, 3045) patients were included. Anaemia occurred in 60% of ND and 93% of DD patients. DD patients used more erythropoiesis-stimulating agents (ESAs; 82% versus 24%) and iron (62% versus 21%) than ND patients. All weekly ESA doses were converted to a weight-adjusted weekly epoetin equivalent dose. The prescribed ESA doses were low to moderate [median 48.2 IU/kg/week (ND), 78.6 IU/kg/week (DD)]. Among ESA-treated patients, 6–21% had haemoglobin (Hb) >13 g/dL and 2–6% had Hb <9 g/dL. Inflammation (C-reactive protein >5 mg/L) was highly prevalent and associated with ERI and higher ESA doses. Higher (>88 IU/kg/week) versus lower (<44 IU/kg/week) ESA doses were associated with a higher risk of MACEs [{ND hazard ratio [HR] 1.36 [95% confidence interval (CI) 1.00–1.86]; DD HR 1.60 [95% CI 1.24–2.06]}. There was no association between iron use and inflammation or MACEs.ConclusionsAnaemia remains highly prevalent in advanced CKD. Patients with anaemia received moderate ESA doses with a relatively low prevalence of iron use. Higher doses of ESA were associated with inflammation and a higher risk of MACE.
|
|
| 24. |
|
|
| 25. |
- Gasparini, Alessandro, et al.
(författare)
-
Prevalence and recognition of chronic kidney disease in Stockholm healthcare
- 2016
-
Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 31:12, s. 2086-2094
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Chronic kidney disease (CKD) is common, but the frequency of albuminuria testing and referral to nephrology care has been difficult to measure. We here characterize CKD prevalence and recognition in a complete healthcare utilization cohort of the Stockholm region, in Sweden. Methods. We included all adult individuals (n = 1 128 058) with at least one outpatient measurement of IDMS-calibrated serum creatinine during 2006-11. Estimated glomerular filtration rate (eGFR) was calculated via the CKD-EPI equation and CKD was solely defined as eGFR <60 mL/min/1.73 m(2). We also assessed the performance of diagnostic testing (albuminuria), nephrology consultations, and utilization of ICD-10 diagnoses. Results. A total of 68 894 individuals had CKD, with a crude CKD prevalence of 6.11% [95% confidence interval (CI): 6.07-6.16%] and a prevalence standardized to the European population of 5.38% (5.33-5.42%). CKD was more prevalent among the elderly (28% prevalence >75 years old), women (6.85 versus 5.24% in men), and individuals with diabetes (17%), hypertension (17%) or cardiovascular disease (31%). The frequency of albuminuria monitoring was low, with 38% of diabetics and 27% of CKD individuals undergoing albuminuria testing over 2 years. Twenty-three per cent of the 16 383 individuals satisfying selected KDIGO criteria for nephrology referral visited a nephrologist. Twelve per cent of CKD patients carried an ICD-10 diagnostic code of CKD. Conclusions. An estimated 6% of the adult Stockholm population accessing healthcare has CKD, but the frequency of albuminuria testing, nephrology consultations and registration of CKD diagnoses was suboptimal despite universal care. Improving provider awareness and treatment of CKD could have a significant public health impact.
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
- Jia, Ting, et al.
(författare)
-
Determinants of Fibroblast Growth Factor-23 and Parathyroid Hormone Variability in Dialysis Patients
- 2013
-
Ingår i: American Journal of Nephrology. - : Karger. - 0250-8095 .- 1421-9670. ; 37:5, s. 462-471
-
Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Treatment strategies for abnormal mineral metabolism in chronic kidney disease are largely based on achieving target ranges of biomarkers that vary considerably over time, yet determinants of their variability are poorly defined. Methods: Observational study including 162 patients of three dialysis cohorts (peritoneal dialysis, n = 78; hemodialysis, n = 49; hemodiafiltration, n = 35). Clinical and biochemical determinants of parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23) variability were analyzed in the peritoneal dialysis cohort. All cohorts were used for comparison of PTH and FGF23 intra-subject variability (intra-class correlation), and their intra-subject variability in different modes of dialysis was explored. Results: High PTH variability was independently associated with lower 25-hydroxyvitamin D concentration and factors of lipid and glucose metabolism, whereas high FGF23 variability was mainly associated with lower baseline serum phosphorous. These results were consistent in multivariate and sensitivity analyses. The intra-subject variability of FGF23 was lower than for PTH irrespective of dialysis mode. Conclusions: Baseline vitamin D status and serum phosphorous are independent determinants of the longitudinal variation in PTH and FGF23, respectively. The clinical utility of FGF23 measurement remains unknown, yet it appears favorable based on its greater temporal stability than PTH in dialysis patients.
|
|
| 29. |
|
|
| 30. |
- Mok, Yejin, et al.
(författare)
-
Albuminuria as a predictor of cardiovascular outcomes in patients with acute myocardial infarction
- 2019
-
Ingår i: Journal of the American Heart Association. - 2047-9980. ; 8:8
-
Tidskriftsartikel (refereegranskat)abstract
- Background. In patients with myocardial infarction ( MI ), reduced kidney function is recognized as an important predictor of poor prognosis, but the impact of albuminuria, a representative measure of kidney damage, has not been extensively evaluated.Methods and Results. In the SCREAM (Stockholm Creatinine Measurements) project (2006-2012), we identified 2469 patients with incident MI with dipstick proteinuria measured within a year before MI (427 patients also had urine albumin to creatinine ratio [ ACR ] measured concurrently) and obtained estimates for ACR with multiple imputation in participants with data solely on dipstick proteinuria. We quantified the association of ACR with the post- MI composite and individual outcomes of all-cause mortality, cardiovascular mortality, recurrent MI , ischemic stroke, or heart failure using Cox models and then evaluated the improvement in C statistic. During a median follow-up of 1.0 year after MI , 1607 participants (65.1%) developed the post- MI composite outcome. Higher ACR levels were independently associated with all outcomes except for ischemic stroke. Per 8-fold higher ACR (eg, 40 versus 5 mg/g), the hazard ratio of composite outcome was 1.21 (95% CI , 1.08-1.35). The addition of the ACR improved the C statistic of the post- MI composite by 0.040 (95% CI, 0.030-0.051). Largely similar results were obtained regardless of diabetic status and when ACR or dipstick was separately analyzed without imputation.Conclusions. In patients with MI , albuminuria was a potent predictor of subsequent outcomes, suggesting the importance of paying attention to the information on albuminuria, in addition to kidney function, in this high-risk population.
|
|
| 31. |
|
|
| 32. |
- Phelan, C M, et al.
(författare)
-
Classification of BRCA1 missense variants of unknown clinical significance
- 2005
-
Ingår i: Journal of Medical Genetics. - : BMJ. - 0022-2593 .- 1468-6244. ; 42:2, s. 138-146
-
Tidskriftsartikel (refereegranskat)abstract
- Background: BRCA1 is a tumour suppressor with pleiotropic actions. Germline mutations in BRCA1 are responsible for a large proportion of breast - ovarian cancer families. Several missense variants have been identified throughout the gene but because of lack of information about their impact on the function of BRCA1, predictive testing is not always informative. Classification of missense variants into deleterious/ high risk or neutral/low clinical significance is essential to identify individuals at risk. Objective: To investigate a panel of missense variants. Methods and results: The panel was investigated in a comprehensive framework that included ( 1) a functional assay based on transcription activation; ( 2) segregation analysis and a method of using incomplete pedigree data to calculate the odds of causality; ( 3) a method based on interspecific sequence variation. It was shown that the transcriptional activation assay could be used as a test to characterise mutations in the carboxy-terminus region of BRCA1 encompassing residues 1396 - 1863. Thirteen missense variants (H1402Y, L1407P, H1421Y, S1512I, M1628T, M1628V, T1685I, G1706A, T1720A, A1752P, G1788V, V1809F, and W1837R) were specifically investigated. Conclusions: While individual classification schemes for BRCA1 alleles still present limitations, a combination of several methods provides a more powerful way of identifying variants that are causally linked to a high risk of breast and ovarian cancer. The framework presented here brings these variants nearer to clinical applicability.
|
|
| 33. |
- Suliman, ME, et al.
(författare)
-
J-shaped mortality relationship for uric acid in CKD
- 2006
-
Ingår i: American journal of kidney diseases : the official journal of the National Kidney Foundation. - : Elsevier BV. - 1523-6838. ; 48:5, s. 761-771
-
Tidskriftsartikel (refereegranskat)
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
|
|
