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3. |
- Lewandowska, A. M., et al.
(författare)
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The influence of balanced and imbalanced resource supply on biodiversity-functioning relationship across ecosystems
- 2016
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Ingår i: Philosophical Transactions of the Royal Society B-Biological Sciences. - : The Royal Society. - 0962-8436 .- 1471-2970. ; 371:1694
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Tidskriftsartikel (refereegranskat)abstract
- Numerous studies show that increasing species richness leads to higher ecosystem productivity. This effect is often attributed to more efficient portioning of multiple resources in communities with higher numbers of competing species, indicating the role of resource supply and stoichiometry for biodiversity ecosystern functioning relationships. Here, we merged theory on ecological stoichiometry with a framework of biodiversity ecosystem functioning to understand how resource use transfers into primary production. We applied a structural equation model to define patterns of diversity productivity relationships with respect to available resources. Meta-analysis was used to summarize the findings across ecosystem types ranging from aquatic ecosystems to grasslands and forests. As hypothesized, resource supply increased realized productivity and richness, but we found significant differences between ecosystems and study types. Increased richness was associated with increased productivity, although this effect was not seen in experiments. More even communities had lower productivity, indicating that biomass production is often maintained by a few dominant species, and reduced dominance generally reduced ecosystem productivity. This synthesis, which integrates observational and experimental studies in a variety of ecosystems and geographical regions, exposes common pattems and differences in biodiversity functioning relationships, and increases the mechanistic understanding of changes in ecosystems productivity.
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5. |
- Wright, Gillian, et al.
(författare)
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The Mid-infrared Instrument for JWST and Its In-flight Performance
- 2023
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Ingår i: Publications of the Astronomical Society of the Pacific. - 0004-6280 .- 1538-3873. ; 135:1046
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Tidskriftsartikel (refereegranskat)abstract
- The Mid-Infrared Instrument (MIRI) extends the reach of the James Webb Space Telescope (JWST) to 28.5 μm. It provides subarcsecond-resolution imaging, high sensitivity coronagraphy, and spectroscopy at resolutions of λ/Δλ ∼ 100-3500, with the high-resolution mode employing an integral field unit to provide spatial data cubes. The resulting broad suite of capabilities will enable huge advances in studies over this wavelength range. This overview describes the history of acquiring this capability for JWST. It discusses the basic attributes of the instrument optics, the detector arrays, and the cryocooler that keeps everything at approximately 7 K. It gives a short description of the data pipeline and of the instrument performance demonstrated during JWST commissioning. The bottom line is that the telescope and MIRI are both operating to the standards set by pre-launch predictions, and all of the MIRI capabilities are operating at, or even a bit better than, the level that had been expected. The paper is also designed to act as a roadmap to more detailed papers on different aspects of MIRI.
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6. |
- Decin, L., et al.
(författare)
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Silicon in the dust formation zone of IRC+10216
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L143-
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Tidskriftsartikel (refereegranskat)abstract
- The interstellar medium is enriched primarily by matter ejected from evolved low and intermediate mass stars. The outflows from these stars create a circumstellar envelope in which a rich gas-phase and dust-nucleation chemistry takes place. We observed the nearest carbon-rich evolved star, IRC + 10216, using the PACS (55-210 mu m) and SPIRE (194-672 mu m) spectrometers on board Herschel. We find several tens of lines from SiS and SiO, including lines from the v = 1 vibrational level. For SiS these transitions range up to J = 124-123, corresponding to energies around 6700 K, while the highest detectable transition is J = 90-89 for SiO, which corresponds to an energy around 8400 K. Both species trace the dust formation zone of IRC + 10216, and the broad energy ranges involved in their detected transitions permit us to derive the physical properties of the gas and the particular zone in which each species has been formed. This allows us to check the accuracy of chemical thermodynamical equilibrium models and the suggested depletion of SiS and SiO due to accretion onto dust grains.
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7. |
- Decin, L., et al.
(författare)
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Warm water vapour in the sooty outflow from a luminous carbon star
- 2010
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 467:7311, s. 64-67
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Tidskriftsartikel (refereegranskat)abstract
- The detection(1) of circumstellar water vapour around the ageing carbon star IRC + 10216 challenged the current understanding of chemistry in old stars, because water was predicted(2) to be almost absent in carbon-rich stars. Several explanations for the water were postulated, including the vaporization of icy bodies (comets or dwarf planets) in orbit around the star(1), grain surface reactions(3), and photochemistry in the outer circumstellar envelope(4). With a single water line detected so far from this one carbon-rich evolved star, it is difficult to discriminate between the different mechanisms proposed. Here we report the detection of dozens of water vapour lines in the far-infrared and sub-millimetre spectrum of IRC + 10216 using the Herschel satellite(5). This includes some high-excitation lines with energies corresponding to similar to 1,000 K, which can be explained only if water is present in the warm inner sooty region of the envelope. A plausible explanation for the warm water appears to be the penetration of ultraviolet photons deep into a clumpy circumstellar envelope. This mechanism also triggers the formation of other molecules, such as ammonia, whose observed abundances(6) are much higher than hitherto predicted(7).
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10. |
- Shafer, Aaron B. A., et al.
(författare)
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Genomics and the challenging translation into conservation practice
- 2015
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Ingår i: Trends in Ecology & Evolution. - : Elsevier. - 0169-5347 .- 1872-8383. ; 30:2, s. 78-87
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Tidskriftsartikel (refereegranskat)abstract
- The global loss of biodiversity continues at an alarming rate. Genomic approaches have been suggested as a promising tool for conservation practice as scaling up to genome-wide data can improve traditional conservation genetic inferences and provide qualitatively novel insights. However, the generation of genomic data and subsequent analyses and interpretations remain challenging and largely confined to academic research in ecology and evolution. This generates a gap between basic research and applicable solutions for conservation managers faced with multifaceted problems. Before the real-world conservation potential of genomic research can be realized, we suggest that current infrastructures need to be modified, methods must mature, analytical pipelines need to be developed, and successful case studies must be disseminated to practitioners.
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11. |
- Sibthorpe, B., et al.
(författare)
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The Vega debris disc: A view from Herschel
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518:Article Number: L130
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Tidskriftsartikel (refereegranskat)abstract
- We present five band imaging of the Vega debris disc obtained using the Herschel Space Observatory. These data span a wavelength range of 70-500 mu m with full-width half-maximum angular resolutions of 5.6-36.9 ''. The disc is well resolved in all bands, with the ring structure visible at 70 and 160 mu m. Radial profiles of the disc surface brightness are produced, and a disc radius of 11 '' (similar to 85AU) is determined. The disc is seen to have a smooth structure thoughout the entire wavelength range, suggesting that the disc is in a steady state, rather than being an ephemeral structure caused by the recent collision of two large planetesimals.
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12. |
- van Hoof, P. A. M., et al.
(författare)
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Herschel images of NGC 6720 : H-2 formation on dust grains
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L137-
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Tidskriftsartikel (refereegranskat)abstract
- Herschel PACS and SPIRE images have been obtained of NGC 6720 (the Ring nebula). This is an evolved planetary nebula with a central star that is currently on the cooling track, due to which the outer parts of the nebula are recombining. From the PACS and SPIRE images we conclude that there is a striking resemblance between the dust distribution and the H-2 emission, which appears to be observational evidence that H-2 forms on grain surfaces. We have developed a photoionization model of the nebula with the Cloudy code which we used to determine the physical conditions of the dust and investigate possible formation scenarios for the H-2. We conclude that the most plausible scenario is that the H-2 resides in high density knots which were formed after the recombination of the gas started when the central star entered the cooling track. Hydrodynamical instabilities due to the unusually low temperature of the recombining gas are proposed as a mechanism for forming the knots. H-2 formation in the knots is expected to be substantial after the central star underwent a strong drop in luminosity about one to two thousand years ago, and may still be ongoing at this moment, depending on the density of the knots and the properties of the grains in the knots.
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13. |
- Vandenbussche, B., et al.
(författare)
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The beta Pictoris disk imaged by Herschel PACS and SPIRE
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518:Article Number: L133
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Tidskriftsartikel (refereegranskat)abstract
- We obtained Herschel PACS and SPIRE images of the thermal emission of the debris disk around the A5V star beta Pic. The disk is well resolved in the PACS filters at 70, 100, and 160 mu m. The surface brightness profiles between 70 and 160 mu m show no significant asymmetries along the disk, and are compatible with 90% of the emission between 70 and 160 mu m originating in a region closer than 200 AU to the star. Although only marginally resolving the debris disk, the maps obtained in the SPIRE 250-500 mu m filters provide full-disk photometry, completing the SED over a few octaves in wavelength that had been previously inaccessible. The small far-infrared spectral index (beta = 0.34) indicates that the grain size distribution in the inner disk (
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14. |
- Acke, B., et al.
(författare)
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Herschel images of Fomalhaut An extrasolar Kuiper belt at the height of its dynamical activity
- 2012
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 540, s. Article Number: A125 -
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Tidskriftsartikel (refereegranskat)abstract
- Context. Fomalhaut is a young (2 +/- 1 x 10(8) years), nearby (7.7 pc), 2 M-circle dot star that is suspected to harbor an infant planetary system, interspersed with one or more belts of dusty debris. Aims. We present far-infrared images obtained with the Herschel Space Observatory with an angular resolution between 5.7 '' and 36.7 '' at wavelengths between 70 mu m and 500 mu m. The images show the main debris belt in great detail. Even at high spatial resolution, the belt appears smooth. The region in between the belt and the central star is not devoid of material; thermal emission is observed here as well. Also at the location of the star, excess emission is detected. We aim to construct a consistent image of the Fomalhaut system. Methods. We use a dynamical model together with radiative-transfer tools to derive the parameters of the debris disk. We include detailed models of the interaction of the dust grains with radiation, for both the radiation pressure and the temperature determination. Comparing these models to the spatially resolved temperature information contained in the images allows us to place strong constraints on the presence of grains that will be blown out of the system by radiation pressure. We use this to derive the dynamical parameters of the system. Results. The appearance of the belt points toward a remarkably active system in which dust grains are produced at a very high rate by a collisional cascade in a narrow region filled with dynamically excited planetesimals. Dust particles with sizes below the blow-out size are abundantly present. The equivalent of 2000 one-km-sized comets are destroyed every day, out of a cometary reservoir amounting to 110 Earth masses. From comparison of their scattering and thermal properties, we find evidence that the dust grains are fluffy aggregates, which indicates a cometary origin. The excess emission at the location of the star may be produced by hot dust with a range of temperatures, but may also be due to gaseous free-free emission from a stellar wind.
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16. |
- Boenink, Rianne, et al.
(författare)
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Trends in kidney transplantation rate across Europe : a study from the ERA Registry
- 2023
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Ingår i: Nephrology Dialysis Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 38:6, s. 1528-1539
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim of this study was to identify trends in total, deceased donor (DD) and living donor (LD) kidney transplantation (KT) rates in European countries. Methods. The European Renal Association (ERA) Registry and the Global Observatory on Donation and Transplantation (GODT) databases were used to obtain the number of KTs in individual European countries between 2010 and 2018. General population counts were obtained from Eurostat or the national bureaus of statistics. The KT rate per million population (p.m.p.) and the average annual percentage change (APC) were calculated. Results. The total KT rate in the 40 participating countries increased with 1.9% annually [95% confidence interval (CI) 1.5, 2.2] from 29.6 p.m.p. in 2010 to 34.7 p.m.p. in 2018, reflecting an increase of 3.4 p.m.p. in the DD-KT rate (from 21.6 p.m.p. to 25.0 p.m.p.; APC 1.9%; 95% CI 1.3, 2.4) and of 1.5 p.m.p. in the LD-KT rate (from 8.1 p.m.p. to 9.6 p.m.p.; APC 1.6%; 95% CI 1.0, 2.3). The trends in KT rate varied widely across European countries. An East-West gradient was observed for DD-KT rate, with Western European countries performing more KTs. In addition, most countries performed fewer LD-KTs. In 2018, Spain had the highest DD-KT rate (64.6 p.m.p.) and Turkey the highest LD-KT rate (37.0 p.m.p.). Conclusions. The total KT rate increased due to a rise in the KT rate from DDs and to a lesser extent from LDs, with large differences between individual European countries.
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17. |
- Cernicharo, J., et al.
(författare)
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Detection of anhydrous hydrochloric acid, HCl, in IRC+10216 with the Herschel SPIRE and PACS spectrometers Detection of HCI in IRC+10216
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L136-
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Tidskriftsartikel (refereegranskat)abstract
- We report on the detection of anhydrous hydrochloric acid (hydrogen chlorine, HCl) in the carbon-rich star IRC+10216 using the spectroscopic facilities onboard the Herschel satellite. Lines from J = 1-0 up to J = 7-6 have been detected. From the observed intensities, we conclude that HCl is produced in the innermost layers of the circumstellar envelope with an abundance relative to H-2 of 5 x 10(-8) and extends until the molecules reach its photodissociation zone. Upper limits to the column densities of AlH, MgH, CaH, CuH, KH, NaH, FeH, and other diatomic hydrides have also been obtained.
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18. |
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19. |
- Royer, P., et al.
(författare)
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PACS and SPIRE spectroscopy of the red supergiant VY CMa
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L145-
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Tidskriftsartikel (refereegranskat)abstract
- With a luminosity > 10(5) L-circle dot and a mass-loss rate of similar to 2 x 10(-4) M-circle dot yr(-1), the red supergiant VY CMa truly is a spectacular object. Because of its extreme evolutionary state, it could explode as supernova any time. Studying its circumstellar material, into which the supernova blast will run, provides interesting constraints on supernova explosions and on the rich chemistry taking place in such complex circumstellar envelopes. We have obtained spectroscopy of VY CMa over the full wavelength range offered by the PACS and SPIRE instruments of Herschel, i.e. 55-672 micron. The observations show the spectral fingerprints of more than 900 spectral lines, of which more than half belong to water. In total, we have identified 13 different molecules and some of their isotopologues. A first analysis shows that water is abundantly present, with an ortho-to-para ratio as low as similar to 1.3:1, and that chemical non-equilibrium processes determine the abundance fractions in the inner envelope.
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21. |
- Shafer, Aaron B A, et al.
(författare)
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Reply to Garner et al
- 2016
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Ingår i: Trends in Ecology & Evolution. - : Elsevier BV. - 0169-5347 .- 1872-8383. ; 31:2, s. 83-84
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Tidskriftsartikel (refereegranskat)
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24. |
- Cuenca-Cambronero, M., et al.
(författare)
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Challenges and opportunities in the use of ponds and pondscapes as Nature-based Solutions
- 2023
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Ingår i: Hydrobiologia. - : Springer Nature. - 0018-8158 .- 1573-5117. ; 850:15, s. 3257-3271
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Tidskriftsartikel (refereegranskat)abstract
- Ponds and "pondscapes" (networks of ponds) are crucial habitats for biodiversity and for delivering multiple benefits to humans, so-called "Nature's Contribution to People", such as climate mitigation and adaptation to climate change, creation, and maintenance of habitat for biodiversity, water purification, flood mitigation and cultural benefits (e.g., recreational possibilities). However, ponds are not often considered as Nature-based Solutions to provide all these benefits. In addition, there is insufficient knowledge on how to manage and restore ponds to maximise their role to increase the resilience of ecosystems and society to climate change. To facilitate improved implementation of ponds as Nature-based Solutions for the delivery of a wide range of Nature Contributions to People, it is important to generate and integrate biodiversity, ecosystems, societal, economic and policy knowledge. Hence, there is a need for evidence-based guidance to support the broader use of ponds. Here, we review the role of ponds and pondscapes in delivering Nature's Contributions to People and provide an overview of the challenges and opportunities for their broader implementation as Nature-based Solutions. Finally, we propose a conceptual framework that can help the implementation of pond Nature-based Solutions, and that outlines future research needs.
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25. |
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26. |
- Koopman, J J E, et al.
(författare)
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Senescence rates in patients with end-stage renal disease: a critical appraisal of the Gompertz model.
- 2011
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Ingår i: Aging Cell. - : Wiley. - 1474-9726 .- 1474-9718. ; Dec, s. 233-238
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Tidskriftsartikel (refereegranskat)abstract
- The most frequently used model to describe the exponential increase in mortality rate over age is the Gompertz equation. Logarithmically transformed, the equation conforms to a straight line, of which the slope has been interpreted as the rate of senescence. Earlier, we proposed the derivative function of the Gompertz equation as a superior descriptor of senescence rate. Here, we tested both measures of the rate of senescence in a population of patients with end-stage renal disease. It is clinical dogma that patients on dialysis experience accelerated senescence, whereas those with a functional kidney transplant have mortality rates comparable to the general population. Therefore, we calculated the age-specific mortality rates for European patients on dialysis (n=274,221; follow-up=594,767 person-years), for European patients with a functioning kidney transplant (n=61,286; follow-up=345,024 person-years), and for the general European population. We found higher mortality rates, but a smaller slope of logarithmical mortality curve for patients on dialysis compared to both patients with a functioning kidney transplant and the general population (p<0.001). A classical interpretation of the Gompertz model would imply that the rate of senescence in patients on dialysis is lower than in patients with a functioning transplant and lower than in the general population. In contrast, the derivative function of the Gompertz equation yielded highest senescence rates for patients on dialysis, whereas the rate was similar in patients with a functioning transplant and the general population. We conclude that the rate of senescence is better described by the derivative function of the Gompertz equation.
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27. |
- Ladjal, D., et al.
(författare)
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Herschel PACS and SPIRE imaging of CW Leonis
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L141-
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Tidskriftsartikel (refereegranskat)abstract
- Herschel PACS and SPIRE images have been obtained over a 30' x 30' area around the well-known carbon star CW Leo (IRC + 10 216). An extended structure is found in an incomplete arc of similar to 22' diameter, which is cospatial with the termination shock due to interaction with the interstellar medium (ISM) as defined by Sahai & Chronopoulos from ultraviolet GALEX images. Fluxes are derived in the 70, 160, 250, 350, and 550 mu m bands in the region where the interaction with the ISM takes place, and this can be fitted with a modified black body with a temperature of 25 +/- 3 K. Using the published proper motion and radial velocity for the star, we derive a heliocentric space motion of 25.1 km s(-1). Using the PACS and SPIRE data and the analytical formula of the bow shock structure, we infer a de-projected standoff distance of the bow shock of R-0 = (8.0 +/- 0.3) x 10(17) cm. We also derive a relative velocity of the star with respect to the ISM of (106.6 +/- 8.7)/ root n(ISM) km s (1), where n(ISM) is the number density of the local ISM.
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28. |
- Maasri, Alain, et al.
(författare)
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A global agenda for advancing freshwater biodiversity research
- 2022
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Ingår i: Ecology Letters. - : Wiley. - 1461-023X .- 1461-0248. ; 25:2, s. 255-263
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Tidskriftsartikel (refereegranskat)abstract
- Global freshwater biodiversity is declining dramatically, and meeting the challenges of this crisis requires bold goals and the mobilisation of substantial resources. While the reasons are varied, investments in both research and conservation of freshwater biodiversity lag far behind those in the terrestrial and marine realms. Inspired by a global consultation, we identify 15 pressing priority needs, grouped into five research areas, in an effort to support informed stewardship of freshwater biodiversity. The proposed agenda aims to advance freshwater biodiversity research globally as a critical step in improving coordinated actions towards its sustainable management and conservation.
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29. |
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30. |
- van Dessel, L., et al.
(författare)
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Pulmonary Hemodynamics and Outcome in a Large Cohort of Patients with Sinus Venosus Septal Defect
- 2020
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Ingår i: Congenital Heart Disease. - : Computers, Materials and Continua (Tech Science Press). - 1747-079X. ; 15:2, s. 69-78
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Tidskriftsartikel (refereegranskat)abstract
- Background: Left-to-right shunt in sinus venosus septal defect (SVSD) may affect resistive (pulmonary vascular resistance-PVR) and elastic (pulmonary artery compliance-PAC) pulmonary artery properties. This study aimed at evaluating (1) impact of age, (2) pulmonary hemodynamics, and (3) outcome in a large cohort of SVSD patients. Methods: This study included 136 patients with SVSD (median age at diagnosis 14 (IQR 5-48) years, 47% male) of which 87 underwent catheterization. Pressures were measured and cardiac output was evaluated using the Fick principle at diagnosis. PVR, PAC and their product (RC time) were calculated. Results: Surgical repair was performed in 128 (94%) at a median age of 13 (IQR 5- 43) years. During a median follow-up time of 31 (IQR 17-55) years, 12 (9%) patients died, 13 (10%) developed heart failure, 4 (3%) Eisenmenger syndrome, 19 (14%) atrial arrhythmia, 6 (4%) sick sinus syndrome and 7 (5%) required pacemaker implantation In those who underwent catheterization, median shunt ratio was 2.5 (IQR 2.0-2.9). Thirty (34%) had mean PA pressure >= 25 mmHg. PVR indexed, PAC indexed, and RC time was 3.5 (IQR 2.4-7.5) WU.m(2) , 1.8 (IQR 1.3-2.5) mL/mmHg.m(2) and 0.39 (0.26-0.53) sec with an inverse hyperbolic relationship between PVR and PAC. Mean PA pressure (P < 0.0001); wedge pressure (P = 0.001), PVR indexed (P = 0.002) and PAC indexed (P = 0.002) changed significantly with age at diagnosis, but shunt ratio did not. Conclusion: SVSD has good long-term outcome, albeit with late morbidities. Thirty-four percent has mean PA pressure >= 25 mmHg, but Eisenmenger syndrome is rare (3%). PVR and PAC are inversely related and change significantly with older age.
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31. |
- Bruijning, Marjolein, et al.
(författare)
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Host-parasite dynamics shaped by temperature and genotype : Quantifying the role of underlying vital rates
- 2022
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Ingår i: Functional Ecology. - : John Wiley & Sons. - 0269-8463 .- 1365-2435. ; 36:2, s. 485-499
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Tidskriftsartikel (refereegranskat)abstract
- Global warming challenges the persistence of local populations, not only through heat-induced stress, but also through indirect biotic changes. We study the interactive effects of temperature, competition and parasitism in the water flea Daphnia magna.We carried out a common garden experiment monitoring the dynamics of Daphnia populations along a temperature gradient. Halfway through the experiment, all populations became infected with the ectoparasite Amoebidium parasiticum, enabling us to study the interactive effects of temperature and parasite dynamics. We combined Integral Projection Models with epidemiological models, parameterized using the experimental data on the performance of individuals within dynamic populations. This enabled us to quantify the contribution of different vital rates and epidemiological parameters to population fitness across temperatures and Daphnia clones originating from two latitudes.Interactions between temperature and parasitism shaped competition, where Belgian clones performed better under infection than Norwegian clones. Infected Daphnia populations performed better at higher than at lower temperatures, mainly due to an increased host capability of reducing parasite loads. Temperature strongly affected individual vital rates, but effects largely cancelled out on a population-level. In contrast, parasitism strongly reduced fitness through consistent negative effects on all vital rates. As a result, temperature-mediated parasitism was more important than the direct effects of temperature in shaping population dynamics. Both the outcome of the competition treatments and the observed extinction patterns support our modelling results.Our study highlights that shifts in biotic interactions can be equally or more important for responses to warming than direct physiological effects of warming, emphasizing that we need to include such interactions in our studies to predict the competitive ability of natural populations experiencing global warming. A free Plain Language Summary can be found within the Supporting Information of this article.
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32. |
- Derner, Ondrej, et al.
(författare)
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Incidence of Kidney Replacement Therapy and Subsequent Outcomes Among Patients With Systemic Lupus Erythematosus : Findings From the ERA Registry
- 2022
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Ingår i: American Journal of Kidney Diseases. - : Elsevier BV. - 0272-6386. ; 79:5, s. 635-645
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Tidskriftsartikel (refereegranskat)abstract
- Rationale & Objective: There is a dearth of data characterizing patients receiving kidney replacement therapy (KRT) for kidney failure due to systemic lupus erythematosus (SLE) and their clinical outcomes. The aim of this study was to describe trends in incidence and prevalence of KRT among these patients as well as to compare their outcomes versus those of patients treated with KRT for diseases other than SLE. Study Design: Retrospective cohort study based on kidney registry data. Setting & Participants: Patients recorded in 14 registries of patients receiving KRT that provided data to the European Renal Association Registry between 1992 and 2016. Predictor: SLE as cause of kidney failure. Outcomes: Incidence and prevalence of KRT, patient survival while receiving KRT, patient and graft survival after kidney transplant, and specific causes of death. Analytical Approach: Kaplan-Meier methods and Cox regression models were fit to compare patient survival between the SLE and non-SLE groups, overall KRT, dialysis, and patient and graft survival after kidney transplant. Results: In total, 1,826 patients commenced KRT for kidney failure due to SLE, representing an incidence of 0.80 per million population (pmp) per year. The incidence remained stable during the study period (annual percent change, 0.1% [95% CI, −0.6% to 0.8%]). Patient survival among patients with SLE receiving KRT was similar to survival in the comparator group (hazard ratio [HR], 1.11 [95% CI, 0.99-1.23]). After kidney transplant, the risk of death was greater among patients with SLE than among patients in the comparator group (HR, 1.25 [95% CI, 1.02-1.53]), whereas the risk of all-cause graft failure was similar (HR, 1.09 [95% CI, 0.95-1.27]). Ten-year patient overall survival during KRT and patient and graft survival after kidney transplant improved over the study period (HRs of 0.71 [95% CI, 0.56-0.91], 0.43 [95% CI, 0.27-0.69], and 0.60 [95% CI, 0.43-0.84], respectively). Patients with SLE receiving KRT were significantly more likely to die of infections (24.8%) than patients in the comparator group (16.9%; P < 0.001). Limitations: No data were available on extrarenal manifestations of SLE, drug treatments, comorbidities, kidney transplant characteristics, or relapses of SLE. Conclusions: The prognosis of patients with SLE receiving KRT has improved over time. Survival of patients with SLE who required KRT was similar compared with patients who required KRT for other causes of kidney failure. Survival following kidney transplants was worse among patients with SLE.
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33. |
- Hruskova, Zdenka, et al.
(författare)
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Characteristics and Outcomes of Patients With Systemic Sclerosis (Scleroderma) Requiring Renal Replacement Therapy in Europe: Results From the ERA-EDTA Registry
- 2019
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Ingår i: American Journal of Kidney Diseases. - : W B SAUNDERS CO-ELSEVIER INC. - 0272-6386 .- 1523-6838. ; 73:2, s. 184-193
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Tidskriftsartikel (refereegranskat)abstract
- Rationale amp; Objective: Data for outcomes of patients with end-stage renal disease (ESRD) secondary to systemic sclerosis (scleroderma) requiring renal replacement therapy (RRT) are limited. We examined the incidence and prevalence of ESRD due to scleroderma in Europe and the outcomes among these patients following initiation of RRT. Study Design: Registry study of incidence and prevalence and a matched cohort study of clinical outcomes. Setting amp; Participants: Patients represented in any of 19 renal registries that provided data to the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry between 2002 and 2013. Predictor: Scleroderma as the identified cause of ESRD. Outcomes: Incidence and prevalence of ESRD from scleroderma. Recovery from RRT dependence, patient survival after ESRD, and graft survival after kidney transplantation. Analytical Approach: Incidence and prevalence were calculated using population data from the European Union and standardized to population characteristics in 2005. Patient and graft survival were compared with 2 age- and sex-matched control groups without scleroderma: (1) diabetes mellitus as the cause of ESRD and (2) conditions other than diabetes mellitus as the cause of ESRD. Survival analyses were performed using Kaplan-Meier analysis and Cox regression. Results: 342 patients with scleroderma (0.14% of all incident RRT patients) were included. Between 2002 and 2013, the range of adjusted annual incidence and prevalence rates of RRT for ESRD due to scleroderma were 0.11 to 0.26 and 0.73 to 0.95 per million population, respectively. Recovery of independent kidney function was greatest in the scleroderma group (7.6% vs 0.7% in diabetes mellitus and 2.0% in other primary kidney diseases control group patients, both Pamp;lt;0.001), though time required to achieve recovery was longer. The 5-year survival probability from day 91 of RRT among patients with scleroderma was 38.9% (95% CI, 32.0%-45.8%), whereas 5-year posttransplantation patient survival and 5-year allograft survival were 88.2% (95% CI, 75.3%-94.6%) and 72.4% (95% CI, 55.0%-84.0%), respectively. Adjusted mortality from day 91 on RRT was higher among patients with scleroderma than observed in both control groups (HRs of 1.25 [95% CI, 1.05-1.48] and 2.00 [95% CI, 1.69-2.39]). In contrast, patient and graft survival after kidney transplantation did not differ between patients with scleroderma and control groups. Limitations: No data for extrarenal manifestations, treatment, or recurrence. Conclusions: Survival of patients with scleroderma who receive dialysis for more than 90 days was worse than for those with other causes of ESRD. Patient survival after transplantation was similar to that observed among patients with ESRD due to other conditions. Patients with scleroderma had a higher rate of recovery from RRT dependence than controls.
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- Stel, Vianda S., et al.
(författare)
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International comparison of trends in patients commencing renal replacement therapy by primary renal disease
- 2019
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Ingår i: Nephrology. - : Wiley. - 1320-5358 .- 1440-1797. ; 24:10, s. 1064-1076
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To examine international time trends in the incidence of renal replacement therapy (RRT) for end-stage renal disease (ESRD) by primary renal disease (PRD). Methods: Renal registries reporting on patients starting RRT per million population for ESRD by PRD from 2005 to 2014, were identified by internet search and literature review. The average annual percentage change (AAPC) with a 95% confidence interval (CI) of the time trends was computed using Joinpoint regression. Results: There was a significant decrease in the incidence of RRT for ESRD due to diabetes mellitus (DM) in Europe (AAPC = −0.9; 95%CI −1.3; −0.5) and to hypertension/renal vascular disease (HT/RVD) in Australia (AAPC = −1.8; 95%CI −3.3; −0.3), Canada (AAPC = −2.9; 95%CI −4.4; −1.5) and Europe (AAPC = −1.1; 95%CI −2.1; −0.0). A decrease or stabilization was observed for glomerulonephritis in all regions and for autosomal dominant polycystic kidney disease (ADPKD) in all regions except for Malaysia and the Republic of Korea. An increase of 5.2–16.3% was observed for DM, HT/RVD and ADPKD in Malaysia and the Republic of Korea. Conclusion: Large international differences exist in the trends in incidence of RRT by primary renal disease. Mapping of these international trends is the first step in defining the causes and successful preventative measures of CKD.
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