Publications by authors named "Carrero J"
Introduction: Little is known regarding the comparison of cardiovascular and kidney outcomes between lupus nephritis (LN) and other etiologies of chronic kidney disease (CKD).
Methods: Using data from the Swedish Renal Registry (2006-2021), we compared long-term outcomes between patients with LN-CKD and patients with CKD due to primary glomerular diseases (PGD) and other CKD causes (Other-CKD, mainly diabetes and nephroangiosclerosis). Adjusted hazard ratios (HRs) of mortality, major adverse cardiovascular events (MACE) and kidney replacement therapy (KRT) were estimated using Cox proportional hazard models.
Background: Knowledge of which medications may lead to acute kidney injury (AKI) is limited, relying mostly on spontaneous reporting in pharmacovigilance systems. We here conducted an exploratory drug-wide association study (DWAS) to screen for associations between dispensed drugs and AKI risk.
Methods: Using two large Danish and Swedish data linkages, we identified AKI hospitalizations occurring between April 1997 and December 2021 in Denmark and between March 2007 and December 2021 in Sweden.
Background: Ageing often affects biomarker production. Yet, clinical/optimal thresholds to guide clinical decisions do not consider this. Serum albumin decreases with age, but hypoalbuminaemia is defined as serum albumin <4.
View Article and Find Full Text PDFImportance: COVID-19 infection has been associated with acute kidney injury. However, its possible association with long-term kidney function is not well understood.
Objective: To investigate whether kidney function decline accelerated after COVID-19 compared with after other respiratory tract infections.
Objective: Low estimated glomerular filtration rate (eGFR) increases the risk of arterial diseases, possibly including abdominal aortic aneurysm (AAA). This study explored the relationship between eGFR (2008 CKD-EPI equation), annual eGFR decline, and subsequent risk of developing AAA in a large, community based sample.
Methods: This was an observational study using complete healthcare records of Stockholm residents free from AAA who underwent routine creatinine testing during 2011 - 2021.
Background: Individual chronic conditions have been linked to kidney function decline; however, the role of multimorbidity (the presence of ≥2 conditions) and multimorbidity patterns remains unclear.
Methods: A total of 3094 individuals from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) were followed for 15 years. Multimorbidity was operationalized as the number of chronic conditions and multimorbidity patterns identified using latent class analysis (LCA).
Reply to "Kidney Failure, Inflammatory Bowel Disease, and Colectomy".
Clin Gastroenterol Hepatol
December 2024
During intestinal and liver invasion by the protozoan parasite , extensive tissue destruction linked to large neutrophil infiltrates is observed. It has been proposed that microbicidal components of neutrophils are responsible for the damage, however, the mechanism by which they are released and act in the extracellular space remains unknown. In previous studies, we have shown that trophozoites induce NET formation, leading to the release of neutrophil granule content into extruded DNA.
View Article and Find Full Text PDFIntroduction: Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.
Methods: DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m recorded 91-730 days apart.
Aims: Mineralocorticoid receptor antagonists (MRA) improve outcomes in heart failure with reduced ejection fraction (HFrEF) but are underused. Point prevalent use has been described, but the kinetics of discontinuation and the extent of reinitiation have not been studied.
Methods And Results: Patients with HFrEF enrolled in the Swedish Heart Failure Registry between 2006 and 2021 were linked to the Prescribed Drug Register.
Article Synopsis
- Process mining techniques can improve the analysis of longitudinal data in clinical epidemiology, but their use has been limited.
- This study proposes an eight-step methodology that combines cohort studies with process mining to uncover disease progression patterns.
- By applying this methodology, researchers found that proton pump inhibitors (PPIs) led to higher risks of kidney decline and all-cause mortality compared to H2 blockers, and they developed a prediction tool for assessing individual risk.
Article Synopsis
- Chronic kidney disease (CKD) is commonly underdiagnosed and undertreated in primary care, and an electronic clinical decision support (CDS) system may enhance its detection and management.
- The study is a 24-month randomized controlled trial involving 66 healthcare centers in Stockholm, comparing a new CDS system with existing methods to improve CKD screening, diagnosis, and management.
- Key outcomes include the number of patients screened for kidney function, the rate of lab retesting in at-risk patients, and improved clinical diagnosis and referral rates for nephrology care.
Article Synopsis
- Glomerular diseases rank as the third most common cause of end-stage kidney disease worldwide, yet their long-term outcomes remain poorly understood.
- In a study involving almost 2,400 patients with primary glomerular diseases, researchers found that these patients typically had lower hospitalization and mortality rates compared to those with chronic kidney disease from common non-communicable diseases.
- Notably, patients with IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS) experienced faster declines in kidney function and higher rates of kidney replacement therapy compared to those with minimal change disease (MCD) and membranous nephropathy (MN), indicating a need for more aggressive treatment approaches for IgAN and F
Background: Uric acid closely relates to both kidney disease and atrial fibrillation (AF), yet the extent to which it influences the kidney-AF association remains uncertain. We examined the relationship between kidney function and risk of AF, accounting for uric acid levels.
Methods: A total of 308,509 individuals in the Swedish Apolipoprotein-Related Mortality Risk (AMORIS) cohort were included and their serum creatinine and uric acid were measured during 1985-1996.
Article Synopsis
- A study was conducted to determine if sodium-glucose cotransporter-2 inhibitors (SGLT-2i) reduce the risk of hyperkalemia and help maintain the use of renin-angiotensin system inhibitors (RASi) in people with type 2 diabetes, compared to dipeptidyl peptidase 4 inhibitors (DPP-4i).
- The research involved nearly 30,000 adults in Stockholm over several years, measuring incidents of hyperkalemia and RASi discontinuation in those starting either SGLT-2i or DPP-4i.
- Results showed that SGLT-2i users had significantly lower rates of hyperkalemia (both mild and
Article Synopsis
- The KDIGO 2024 Guidelines for chronic kidney disease (CKD) are a significant update, occurring 12 years after the influential 2012 guidelines.
- These new guidelines emphasize the integration of recent therapies that have shown success in treating CKD and related cardiovascular issues, making them relevant for both children and adults.
- The commentary highlights that despite advancements, the diagnosis and treatment of CKD remain subpar across Europe, suggesting that these guidelines serve as a crucial call to action for improving care in this area.
Article Synopsis
- Gastric metaplasia, which can occur due to chronic inflammation from Helicobacter pylori (Hp) infection or autoimmune gastritis (AIG), raises the risk of developing gastric cancer.
- Research on mouse models and human tissues revealed that both Hp infection and AIG caused similar metaplastic changes, although some subtle differences in cell types were noted.
- A specific metaplastic subtype associated with cancer, indicated by the biomarker ANPEP/CD13, was found in both conditions, suggesting a shared risk for cancer and the potential for improved patient detection strategies.
Background And Aims: The burden and outcomes of inflammation in patients with atherosclerotic cardiovascular disease (ASCVD) are not well defined beyond the controlled settings of trials and research cohorts.
Methods: This was an observational study of ASCVD adults undergoing C-reactive protein testing in Stockholm's healthcare (2007-21). After excluding C-reactive protein tests associated with acute illness or medications/conditions that bias C-reactive protein interpretation, systemic inflammation was evaluated over a 3-month ascertainment window.
Article Synopsis
- Understanding the significance of kidney disease (KD) in hospitalized patients, this guideline aims to provide evidence-based nutritional recommendations due to the metabolic and nutritional impacts of acute (AKD) and chronic kidney disease (CKD).
- The guideline development involved a systematic review of literature from 1999 to 2020, leading to over 30 recommendations on assessing nutritional status, identifying at-risk patients, and integrating nutrition with kidney replacement therapy (KRT) through a consensus process.
- The conclusion emphasizes the diverse nutritional needs of patients with KD, advocating for personalized nutrition strategies to prevent underfeeding and overfeeding, and offering practical advice for daily clinical practice.
Article Synopsis
- Chronic kidney disease (CKD) significantly affects patients' emotional well-being and daily lives, with emotional responses like worry and shock reported at diagnosis.
- The study involved interviews with 105 CKD patients across four countries, revealing that disease severity correlates with increased impacts on mental health and daily functioning, particularly for those in advanced stages or on dialysis.
- The results highlight a need for better patient education and support, as many participants felt inadequately informed about their condition and sought additional information to manage their CKD experience.
Background And Objectives: Preclinical studies suggest that acute kidney injury (AKI) results in biochemical and pathologic changes in the brain. We aimed to explore the association between experiencing AKI and subsequent risks of developing dementia.
Methods: We conducted a study involving individuals aged 65 years and older in Stockholm from 2006 to 2019, who were free from dementia diagnosis and had data on kidney function.