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- Delanaye, Pierre, et al.
(författare)
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CKD : A Call for an Age-Adapted Definition
- 2019
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Ingår i: Journal of the American Society of Nephrology. - 1046-6673. ; 30:10, s. 1785-1805
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Forskningsöversikt (refereegranskat)abstract
- Current criteria for the diagnosis of CKD in adults include persistent signs of kidney damage, such as increased urine albumin-to-creatinine ratio or a GFR below the threshold of 60 ml/min per 1.73 m2 This threshold has important caveats because it does not separate kidney disease from kidney aging, and therefore does not hold for all ages. In an extensive review of the literature, we found that GFR declines with healthy aging without any overt signs of compensation (such as elevated single-nephron GFR) or kidney damage. Older living kidney donors, who are carefully selected based on good health, have a lower predonation GFR compared with younger donors. Furthermore, the results from the large meta-analyses conducted by the CKD Prognosis Consortium and from numerous other studies indicate that the GFR threshold above which the risk of mortality is increased is not consistent across all ages. Among younger persons, mortality is increased at GFR <75 ml/min per 1.73 m2, whereas in elderly people it is increased at levels <45 ml/min per 1.73 m2 Therefore, we suggest that amending the CKD definition to include age-specific thresholds for GFR. The implications of an updated definition are far reaching. Having fewer healthy elderly individuals diagnosed with CKD could help reduce inappropriate care and its associated adverse effects. Global prevalence estimates for CKD would be substantially reduced. Also, using an age-specific threshold for younger persons might lead to earlier identification of CKD onset for such individuals, at a point when progressive kidney damage may still be preventable.
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| 2. |
- Melsom, A., et al.
(författare)
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Exploring drift simulations from ocean circulation experiments: application to cod eggs and larval drift
- 2022
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Ingår i: Climate Research. - : Inter-Research Science Center. - 0936-577X .- 1616-1572. ; 86, s. 145-162
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Tidskriftsartikel (refereegranskat)abstract
- Drift models are commonly used to study the transport of early life stages of fish and other marine organisms. Various approaches may be applied to examine the distribution and variability of ocean trajectory pathways. In the present study, we compare results using passive Eulerian tracers and Lagrangian float trajectories that are embedded in numerical models. We supplement this analysis by applying an offline model for drift computations. The contrasts in the results from the various configurations are mainly due to differences in drift depth. Simulations were performed using horizontal resolutions of 4 and 0.8 km. The higher-resolution experiment gives somewhat more realistic results for the drift time from Lofoten to the Tromsoflaket bank at the southwestern entrance of the Barents Sea. Furthermore, differences in results between simulation years are much larger than the differences that arise from the choice of model configuration. Climate variability at high latitudes on a multi-decadal time scale is dominated by large interannual variability superimposed on an underlying moderate warming trend. We conclude that a properly configured offline drift model using hourly or 2-hourly results from a simulation with a horizontal resolution of 1 km or finer is the best approach for investigations of trajectory pathways. The flexibility of an offline drift model is also highly advantageous in biological contexts, as it easily allows for a variety of ways in which behavioural characteristics can be parameterized, including descriptions that are defined after the ocean circulation simulation has been executed.
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