Doctoral Defence in Medical Sciences – Telma Huld Ragnarsdóttir

On Thursday, 29 October, Telma Huld Ragnarsdóttir will defend her doctoral thesis in medical sciences at the Faculty of Medicine, University of Iceland. The thesis is entitled: Community-Acquired Acute Kidney Injury: Risk Factors, Outcomes and the Prognostic Significance of Small Changes in Serum Creatinine.

The opponents are Dr Eric Hoste, Professor at Ghent University and Ghent University Hospital in Ghent, Belgium, and Dr Marie Evans, Professor at Karolinska Institutet and Karolinska University Hospital in Stockholm, Sweden.

Runólfur Pálsson, Professor, was the principal supervisor, and Ólafur Skúli Indriðason, Consultant Physician, was the supervisor. The doctoral committee also included Margrét Ólafía Tómasdóttir, Assistant Professor, Vicente Sanchez-Brunete, Consultant Physician, and Ólafur Samúelsson, Consultant Physician.

Einar Stefán Björnsson, Professor, will chair the ceremony, which will take place in the Ceremonial Hall of the University of Iceland and begin at 13:00.

Abstract

This prospective cohort study examined community-acquired acute kidney injury (CA-AKI) in patients presenting to the emergency department at Landspitali University Hospital over 11 months. It compared 512 AKI episodes in 488 patients with 1,024 matched controls, following them for 15 months. AKI was associated with recent vomiting, diarrhea, urinary retention, use of NSAIDs, ACE inhibitors/ARBs and diuretics, as well as diabetes, chronic kidney disease (CKD) and smoking. AKI patients were more often admitted, stayed longer, and had higher 90-day and one-year mortality, even at stage 1. They were also more likely to develop recurrent AKI and CKD. Among controls, both small increases (10–49%) and decreases (≥10%) in serum creatinine were linked to higher one-year mortality, showing a U-shaped relationship. The findings underline the risks of volume depletion and NSAID and RAS-inhibitor use, the need for patient and clinician education, and the importance of early recognition and follow-up.

About the Doctoral Candidate

Telma Huld Ragnarsdóttir was born in Reykjavík in 1988. She graduated from the Natural Sciences Programme at Menntaskólinn við Hamrahlíð in 2007, obtained a B.Sc. degree in medical sciences from the University of Iceland in 2010, and completed her medical degree in 2013. She completed her foundation training in 2014 and her specialist training in internal medicine at Landspítali – The National University Hospital of Iceland in 2023. She also obtained the MRCP (UK) qualification in internal medicine in 2022.

She currently works as a consultant physician in internal medicine at Landspítali and holds a position as an adjunct in communication studies at the University of Iceland.

Telma's mother is Elín Lára Jónsdóttir, her father is Ragnar Örn Jónsson, and her stepfather is Snorri Páll Einarsson. Her husband is Kristinn Jakobsson, and their children are Kristjana Lind, Kristinn Þór, Katrín Emma, Katla Rakel and Kári Týr.