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Article: Twenty-Three-Year Trends in the Use of Potentially Nephrotoxic Drugs in Denmark.

Enevoldsen, Frederik Cosedis / Christiansen, Christian Fynbo / Jensen, Simon Kok

2023 Volume 15, Page(s) 275–287

Abstract: Background: The occurrence of acute and chronic kidney diseases has been rising in the last decades. Although drug use is a common risk factor for impaired kidney function, changes in utilization of potential nephrotoxic drugs have received little ... ...

Abstract	Background: The occurrence of acute and chronic kidney diseases has been rising in the last decades. Although drug use is a common risk factor for impaired kidney function, changes in utilization of potential nephrotoxic drugs have received little attention. Purpose: To describe temporal trends in the utilization of potentially nephrotoxic drugs in Denmark between 1999 and 2021. Methods: Specific drugs known or suspected to be nephrotoxic were identified in the literature. Data on the sold defined daily doses (DDDs) of potentially nephrotoxic drugs between 1999 and 2021 were retrieved using the Danish Register of Medical Product Statistics. Trends in sales of DDDs per 1000 inhabitants per day were tabulated and illustrated graphically. Results: From 1999 to 2021, the total sale of all selected drugs increased from 286 to 457 DDDs per 1000 inhabitants per day. The overall sale reached a preliminary peak in 2012 with 449 DDDs per 1000 inhabitants per day and remained relatively stable thereafter until reaching an all-time high in 2021 with 457 DDDs per 1000 inhabitants per day. Contributing with the majority in volume, sales of drugs inhibiting the renin-angiotensin-aldosterone system (RAAS) increased dramatically throughout the period. The same was observed for acetaminophen, methotrexate, tacrolimus, and iodinated contrast dye. In contrast, the sales of diuretics, acetylsalicylic acid, and ciclosporin decreased during the last decade of the study period. Conclusion: From 1999-2021 considerable changes in sales of potentially nephrotoxic drugs were observed. In general, the sales increased, in volume predominated by RAAS inhibiting drugs. This increase in sales of potential nephrotoxins could contribute to an increasing occurrence of kidney diseases.
Language	English
Publishing date	2023-03-07
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494772-6
ISSN	1179-1349
ISSN	1179-1349
DOI	10.2147/CLEP.S397415
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Article ; Online: Effect of the Refitted Race-Free eGFR Formula on the CKD Prevalence and Mortality in the Danish Population.

Vestergaard, Søren Viborg / Heide-Jørgensen, Uffe / Birn, Henrik / Christiansen, Christian Fynbo

Clinical journal of the American Society of Nephrology : CJASN

2022 Volume 17, Issue 3, Page(s) 426–428

MeSH term(s)	Creatinine ; Denmark/epidemiology ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Prevalence ; Renal Insufficiency, Chronic/epidemiology
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2022-01-11
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.14491121
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Article ; Online: Comorbidity, Criminality, and Costs of Patients Treated for Gambling Disorder in Denmark.

Vestergaard, Søren Viborg / Ulrichsen, Sinna Pilgaard / Dahl, Christian Møller / Marcussen, Thomas / Christiansen, Christian Fynbo

Journal of gambling studies

2023 Volume 39, Issue 4, Page(s) 1765–1780

Abstract: Gambling disorder is associated with increased mental comorbidity, unhealthy lifestyle, criminality, and costs-of-illness, but the available evidence is mainly based on self-reported survey data. We examined the registry-recorded mental and somatic ... ...

Abstract	Gambling disorder is associated with increased mental comorbidity, unhealthy lifestyle, criminality, and costs-of-illness, but the available evidence is mainly based on self-reported survey data. We examined the registry-recorded mental and somatic comorbidities, medication use, criminality, and costs-of-illness associated with gambling disorder. We identified individuals diagnosed with or treated for gambling disorder in hospitals or specialized treatment centers during 2013-2017 and matched them by age and sex to general population comparisons. Using individual-level healthcare and socioeconomic registries, we characterized their history of mental and somatic comorbidities, medication use, and criminality. We estimated their cost-of-illness of welfare services (direct) and lowered productivity (indirect) using the human capital approach. We identified 1381 individuals with gambling disorder, primarily young (median age: 34 years) men (87%). Individuals with gambling disorder more frequently than their comparisons had previous hospital-recorded comorbidity [e.g., myocardial infarction (0.8% vs. 0.5%)], medication use [e.g., respiratory system drugs (35.6% vs. 28.6%)], and hospital-recorded or pharmacologically treated mental comorbidity [e.g., depression (39.8% vs. 14.9%)]. Also, sentenced criminality was much more common in individuals with gambling disorder (7.0%) than in comparisons (1.1%). The estimated attributable direct costs were €4.0 M corresponding to €2.9 K per person with gambling disorder, and attributable indirect costs were €17.6 M, corresponding to €13.2 K per person with gambling disorder in 2018. In conclusion, individuals diagnosed with or treated for gambling disorder have a high burden of mental and somatic comorbidities as well as criminality compared with the general population. This needs attention to minimize the societal and personal costs of gambling disorder.
MeSH term(s)	Male ; Humans ; Adult ; Gambling/psychology ; Comorbidity ; Denmark
Language	English
Publishing date	2023-10-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2016895-0
ISSN	1573-3602 ; 1050-5350
ISSN (online)	1573-3602
ISSN	1050-5350
DOI	10.1007/s10899-023-10255-6
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Article ; Online: Hospital readmission after acute kidney injury--why?*.

Christiansen, Christian Fynbo

Critical care medicine

2015 Volume 43, Issue 2, Page(s) 490–491

MeSH term(s)	Acute Kidney Injury/physiopathology ; Critical Illness ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Patient Readmission/statistics & numerical data
Language	English
Publishing date	2015-02
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000000778
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Zs.A 1261: Show issues

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Article ; Online: Hypoparathyroidism and mortality after total thyroidectomy: A nationwide matched cohort study.

Reinke, Rasmus / Udholm, Sebastian / Christiansen, Christian Fynbo / Almquist, Martin / Londero, Stefano / Rejnmark, Lars / Rasmussen, Thomas Bøjer / Rolighed, Lars

Clinical endocrinology

2024 Volume 100, Issue 4, Page(s) 408–415

Abstract: Objective: Total thyroidectomy (TT) carries a risk of hypoparathyroidism (hypoPT). Recently, hypoPT has been associated with higher overall mortality rates. We aimed to evaluate the frequency of hypoPT and mortality in patients undergoing TT in Denmark ... ...

Abstract	Objective: Total thyroidectomy (TT) carries a risk of hypoparathyroidism (hypoPT). Recently, hypoPT has been associated with higher overall mortality rates. We aimed to evaluate the frequency of hypoPT and mortality in patients undergoing TT in Denmark covering 20 years. Design: Retrospective Cohort study. Patients and measurements: Using population-based registries, we identified all Danish individuals who had undergone TT between January 1998 and December 2017. We included a comparison cohort by randomly selecting 10 citizens for each patient, matched on sex and birth year. HypoPT was defined as treatment with active vitamin D after 12 months postoperatively. We used cumulative incidence to calculate risks and Cox regression to compare the rate of mortality between patients and the comparison cohort. We evaluated patients in different comorbidity groups using the Charlson Comorbidity Index and by different indications for surgery. Results: 7912 patients underwent TT in the period. The prevalence of hypoPT in the study period was 16.6%, 12 months postoperatively. After adjusting for potential confounders the risk of death due to any causes (hazard ratio; 95% confidence intervals) following TT was significantly increased (1.34; 1.15-1.56) for patients who developed hypoPT. However, subgroup analysis revealed mortality was only increased in malignancy cases (2.48; 1.99-3.10) whereas mortality was not increased when surgery was due to benign indications such as goitre (0.88; 0.68-1.15) or thyrotoxicosis (0.86; 0.57-1.28). Conclusions: The use of active vitamin D for hypoPT was prevalent one year after TT. Patients with hypoPT did not have an increased risk of mortality following TT unless the indication was due to malignancy.
MeSH term(s)	Humans ; Cohort Studies ; Retrospective Studies ; Thyroidectomy/adverse effects ; Hypoparathyroidism/etiology ; Hypoparathyroidism/complications ; Neoplasms/complications ; Vitamin D ; Postoperative Complications/etiology
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2024-02-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.15037
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Zs.A 814: Show issues

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Article ; Online: Temporal changes in incidence of hospital-diagnosed acute pyelonephritis: A 19-year population-based Danish cohort study.

Svingel, Lise Skovgaard / Christiansen, Christian Fynbo / Birn, Henrik / Søgaard, Kirstine Kobberøe / Nørgaard, Mette

IJID regions

2023 Volume 9, Page(s) 104–110

Abstract: Objectives: To examine temporal changes in the incidence of hospital-diagnosed acute pyelonephritis (APN) and characterize associated demographics.: Methods: Cohort study including Danish patients with hospital-diagnosed APN during 2000-2018, ... ...

Abstract	Objectives: To examine temporal changes in the incidence of hospital-diagnosed acute pyelonephritis (APN) and characterize associated demographics. Methods: Cohort study including Danish patients with hospital-diagnosed APN during 2000-2018, identified by International Classification of Diseases, 10 Results: We included 66,937 hospital-diagnosed APN episodes in 57,162 patients. From 2000 to 2018, the incidence increased from 6.8 (95% CI: 6.8-6.8) to 15.4 (95% CI: 15.4-15.4) in women and from 2.7 (95% CI: 2.7-2.7) to 4.5 (95% CI: 4.5-4.5) in men. Among infants, the rate rose from 7.4 (95% CI: 7.4-7.4) to 64.8 (95% CI: 64.7-64.9) in girls and from 17.1 (95% CI: 17.1-17.2) to 52.5 (95% CI: 52.4-52.6) in boys. Concomitant declines were observed in incidences of hospital-diagnosed unspecified urinary tract infections and sepsis. Conclusion: The APN incidence roughly doubled during 2000-2018. The increase was largely driven by a prominently increasing incidence among young children which was not explained by the enlarging prevalence of congenital anomalies of the kidney and urinary tract.
Language	English
Publishing date	2023-10-12
Publishing country	England
Document type	Journal Article
ISSN	2772-7076
ISSN (online)	2772-7076
DOI	10.1016/j.ijregi.2023.10.003
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Article ; Online: Twenty-four-Year Trends in Incidence and Mortality of Nephrotic Syndrome: A Population-Based Cohort Study.

Vestergaard, Søren Viborg / Birn, Henrik / Jensen, Simon Kok / Sørensen, Henrik Toft / Nitsch, Dorothea / Christiansen, Christian Fynbo

Epidemiology (Cambridge, Mass.)

2023 Volume 34, Issue 3, Page(s) 411–420

Abstract: Background: With the increasing prevalence of risk factors for nephrotic syndrome, updated epidemiologic data on the syndrome are needed. We examined its age- and sex-specific incidence, histopathology, and mortality over 24 years.: Methods: This ... ...

Abstract	Background: With the increasing prevalence of risk factors for nephrotic syndrome, updated epidemiologic data on the syndrome are needed. We examined its age- and sex-specific incidence, histopathology, and mortality over 24 years. Methods: This nationwide cohort study included all adults with first-time-recorded nephrotic syndrome in Denmark during 1995-2018 using the Danish National Patient Registry. We obtained data on age, sex, hospital-diagnosed comorbidities, and histopathologic findings. We computed overall, and age- and sex-specific, incidence rates of nephrotic syndrome, 1- and 5-year mortality by calendar period, and 1-year hazard ratios (HRs) of death using Cox models. Results: We identified 3,970 adults with first-time nephrotic syndrome diagnosis. Incidence was highest in men and increased with age to 11.77 per 100,000 person-years (95% confidence interval [CI]: 10.21-13.32) in men aged 80+ years, and 6.56 per 100,000 person-years (95% CI: 5.71-7.41) in women aged 80+ years. Incidence of nephrotic syndrome increased from 3.35 per 100,000 person-years (95% CI: 3.12-3.58) in 1995-2000 to 4.30 per 100,000 person-years (95% CI: 4.05-4.54) in 2013-2018. Over time, 1-year mortality of nephrotic syndrome was stable at 13%-16%, but HR of death was 0.54 (95% CI: 0.42-0.69), adjusted for age, sex, and comorbidities, in 2013-2018 compared with 1995-2000. Subdistribution of glomerulopathies was stable over time with membranous nephropathy and minimal change disease being the most common. Conclusion: During 1995-2018, the incidence of recorded adult nephrotic syndrome increased slightly, and the adjusted mortality of nephrotic syndrome decreased markedly. Whether these findings reflect changes in epidemiology or awareness and coding of nephrotic syndrome, remains to be clarified.
MeSH term(s)	Adult ; Male ; Humans ; Female ; Incidence ; Cohort Studies ; Nephrotic Syndrome/epidemiology ; Nephrotic Syndrome/etiology ; Comorbidity ; Proportional Hazards Models ; Denmark/epidemiology
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1053263-8
ISSN	1531-5487 ; 1044-3983
ISSN (online)	1531-5487
ISSN	1044-3983
DOI	10.1097/EDE.0000000000001576
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Zs.A 3121: Show issues

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Article ; Online: Out-of-hours discharge from intensive care: certain about uncertainty.

Christiansen, Christian Fynbo / Flaatten, Hans

Intensive care medicine

2018 Volume 44, Issue 9, Page(s) 1545–1547

MeSH term(s)	After-Hours Care ; Critical Care ; Humans ; Intensive Care Units ; Patient Discharge ; Patient Readmission ; Uncertainty
Language	English
Publishing date	2018-07-31
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-018-5318-2
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Zs.A 1089: Show issues

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Article ; Online: Correction to: Mortality of older acutely admitted medical patients after early discharge from emergency departments: a nationwide cohort study.

Aasbrenn, Martin / Christiansen, Christian Fynbo / Esen, Buket Öztürk / Suetta, Charlotte / Nielsen, Finn Erland

BMC geriatrics

2021 Volume 21, Issue 1, Page(s) 517

Language	English
Publishing date	2021-09-29
Publishing country	England
Document type	Published Erratum
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-021-02420-6
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Article: Oral anticoagulant treatment and risk of kidney disease-a nationwide, population-based cohort study.

Vestergaard, Ane Emilie Friis / Jensen, Simon Kok / Heide-Jørgensen, Uffe / Adelborg, Kasper / Birn, Henrik / Carrero, Juan-Jesus / Christiansen, Christian Fynbo

Clinical kidney journal

2023 Volume 17, Issue 1, Page(s) sfad252

Abstract: Background: Direct oral anticoagulants (DOACs) are recommended as first-line treatment of atrial fibrillation. Whether DOAC use is associated with lower risks of kidney complications compared with vitamin K antagonists (VKAs) remains unclear. We ... ...

Abstract	Background: Direct oral anticoagulants (DOACs) are recommended as first-line treatment of atrial fibrillation. Whether DOAC use is associated with lower risks of kidney complications compared with vitamin K antagonists (VKAs) remains unclear. We examined this association in a nationwide, population-based cohort study. Methods: We conducted a cohort study including patients initiating oral anticoagulant treatment within 3 months after an atrial fibrillation diagnosis in Denmark during 2012-18. Using routinely collected creatinine measurements from laboratory databases, we followed patients in an intention-to-treat approach for acute kidney injury (AKI) and chronic kidney disease (CKD) progression. We used propensity-score weighting to balance baseline confounders, computed weighted risks and weighted hazard ratios (HRs) with 95% confidence intervals (CIs) comparing DOACs with VKAs. We performed several subgroup analyses and a per-protocol analysis. Results: We included 32 781 persons with atrial fibrillation initiating oral anticoagulation (77% initiating DOACs). The median age was 75 years, 25% had a baseline estimated glomerular filtration rate <60 mL/min/1.73 m Conclusions: Initiation of DOACs was associated with a decreased risk of AKI and CKD progression compared with VKAs. Despite the potential limitations of observational studies, our findings support the need for increased clinical awareness to prevent kidney complications among patients who initiate oral anticoagulants.
Language	English
Publishing date	2023-10-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfad252
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Zs.A 6587: Show issues

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