Publications by authors named "Dag O Dahle"

4 Publications

  • Page 1 of 1

Relative and absolute cancer risks among Nordic kidney transplant recipients-a population-based study.

Transpl Int 2020 12 25;33(12):1700-1710. Epub 2020 Sep 25.

Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Kidney transplant recipients (KTRs) have an increased cancer risk compared to the general population, but absolute risks that better reflect the clinical impact of cancer are seldom estimated. All KTRs in Sweden, Norway, Denmark, and Finland, with a first transplantation between 1995 and 2011, were identified through national registries. Post-transplantation cancer occurrence was assessed through linkage with cancer registries. We estimated standardized incidence ratios (SIR), absolute excess risks (AER), and cumulative incidence of cancer in the presence of competing risks. Overall, 12 984 KTRs developed 2215 cancers. The incidence rate of cancer overall was threefold increased (SIR 3.3, 95% confidence interval [CI]: 3.2-3.4). The AER of any cancer was 1560 cases (95% CI: 1468-1656) per 100 000 person-years. The highest AERs were observed for nonmelanoma skin cancer (838, 95% CI: 778-901), non-Hodgkin lymphoma (145, 95% CI: 119-174), lung cancer (126, 95% CI: 98.2-149), and kidney cancer (122, 95% CI: 98.0-149). The five- and ten-year cumulative incidence of any cancer was 8.1% (95% CI: 7.6-8.6%) and 16.8% (95% CI: 16.0-17.6%), respectively. Excess cancer risks were observed among Nordic KTRs for a wide range of cancers. Overall, 1 in 6 patients developed cancer within ten years, supporting extensive post-transplantation cancer vigilance.
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http://dx.doi.org/10.1111/tri.13734DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756726PMC
December 2020

A rapid and sustained improvement of calcification propensity score (serum T ) after successful kidney transplantation: Reanalysis of a randomized controlled trial of ibandronate.

Clin Transplant 2017 Dec 26;31(12). Epub 2017 Oct 26.

Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

A serum test called T assesses the overall propensity for calcification of the blood and is associated with cardiovascular outcomes. We aimed to examine T over time in kidney transplant recipients and also address any effects of ibandronate. Serum samples taken from kidney transplant patients included in a prospective, randomized placebo controlled study of ibandronate were analyzed in retrospect. Adequate analyses were performed at baseline (approximately 3 weeks after transplantation) in 129 patients, at 10 weeks in 127 patients and at 1 year in 123 patients. There were no statistical differences between ibandronate and placebo treatment in terms of T at 10 weeks (P = .094) or at 1 year (P = .116). Baseline T was a significant covariate (P < .0001) for T scores at 10 weeks and 1 year. In the total cohort, there was a highly significant (P < .0001) increase in T of 26.6% after 10 weeks and T remained stable after 1 year. T change was inversely correlated to phosphate of -0.515 (P < .0001) and to change in serum albumin (P < .03). We found that T increased from baseline to 10 weeks after transplantation with no further change after 1 year. Ibandronate had no effect on T .
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http://dx.doi.org/10.1111/ctr.13131DOI Listing
December 2017

Plasma levels of marine n-3 polyunsaturated fatty acids and renal allograft survival.

Nephrol Dial Transplant 2016 Jan 25;31(1):160-7. Epub 2015 Sep 25.

Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.

Background: Marine n-3 polyunsaturated fatty acids (PUFAs) may exert beneficial effects on inflammation, fibrosis, endothelial function, lipid profile and blood pressure that may prevent graft loss.

Methods: In this observational cohort study in Norwegian renal transplant recipients (n = 1990), transplanted between 1999 and 2011, associations between plasma marine n-3 PUFA levels and graft loss were assessed by multivariable Cox proportional hazard regression analysis. Plasma phospholipid fatty acid composition was determined by gas chromatography and individual fatty acids recorded as weight percentage (wt%) of total fatty acids in a stable phase 10 weeks after transplantation.

Results: During a median follow-up time of 6.8 years, 569 (28.6%) renal allografts were lost, either due to patient death (n = 340, 59.8% of graft loss) or graft loss in surviving patients (n = 229, 40.2%). Plasma marine n-3 PUFA levels ranged from 1.35 to 23.87 wt%, with a median level of 7.95 wt% (interquartile range 6.20-10.03 wt%). When adjusting for established graft loss risk factors, there was a 11% reduced risk of graft loss for every 1.0 wt% increase in marine n-3 PUFA level [adjusted hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.84-0.93], and a 10% reduced risk of graft loss in surviving patients (adjusted HR 0.90; 95% CI 0.84-0.97).

Conclusion: High levels of plasma marine n-3 PUFAs were associated with better renal allograft survival.
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http://dx.doi.org/10.1093/ndt/gfv339DOI Listing
January 2016

The association between marine n-3 polyunsaturated fatty acid levels and survival after renal transplantation.

Clin J Am Soc Nephrol 2015 Jul 10;10(7):1246-56. Epub 2015 Jun 10.

Department of Nephrology, Aarhus University Hospital, Aarhus, Denmark.

Background And Objectives: Several studies have reported beneficial cardiovascular effects of marine n-3 polyunsaturated fatty acids. To date, no large studies have investigated the potential benefits of marine n-3 polyunsaturated fatty acids in recipients of renal transplants.

Design, Setting, Participants, & Measurements: In this observational cohort study of 1990 Norwegian recipients of renal transplants transplanted between 1999 and 2011, associations between marine n-3 polyunsaturated fatty acid levels and mortality were investigated by stratified analysis and multivariable Cox proportional hazard regression analysis adjusting for traditional and transplant-specific mortality risk factors. Marine n-3 polyunsaturated fatty acid levels in plasma phospholipids were measured by gas chromatography in a stable phase 10 weeks after transplantation.

Results: There were 406 deaths (20.4%) during a median follow-up period of 6.8 years. Mortality rates were lower in patients with high marine n-3 polyunsaturated fatty acid levels (≥7.95 weight percentage) compared with low levels (<7.95 weight percentage) for all age categories (pooled mortality rate ratio estimate, 0.69; 95% confidence interval, 0.57 to 0.85). When divided into quartiles according to marine n-3 polyunsaturated fatty acid levels, patients in the upper quartile compared with the lower quartile had a 56% lower risk of death (adjusted hazard ratio, 0.44; 95% confidence interval, 0.26 to 0.75) using multivariable Cox proportional hazard regression analysis. There was a lower hazard ratio for death from cardiovascular disease with high levels of marine n-3 polyunsaturated fatty acid and a lower hazard ratio for death from infectious disease with high levels of the marine n-3 polyunsaturated fatty acid eicosapentaenoic acid, whereas there was no association between total or individual marine n-3 polyunsaturated fatty acid levels and cancer mortality.

Conclusions: Higher plasma phospholipid marine n-3 polyunsaturated fatty acid levels were independently associated with better patient survival.
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http://dx.doi.org/10.2215/CJN.11931214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491303PMC
July 2015
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