Marie Evans

Research team leader and principal investigator

PhD supervisor: Ehab Al-Sodany (main); Joakim Österman (main); Jenny Wrackefeldt (main); Aurora Caldinelli (co); Barbara Saltzinger (co); Alexandra Nowak (co); Charlekleia Chrysostomou (co); Christina Montgomerie (co)

Post-doc: Dr Frida Welander

Researchers: Dr Helena Rydell; Dr Ulrika Hahn-Lundström

Main reserach collaborators Karolinska Institutet: professor Juan-Jesus Carrero (KI-MEB); professor Peter Stenvinkel (KI-CLINTEC); Ass prof Karolina Kublickiene (KI-CLINTEC);  Ass prof Karolina Szummer (KI-MedH); Dr Julia Wijkström (KI-CLINTEC); Ass prof Peter Barany (KI-CLINTEC)

National research collaboration: Chair of the Swedish nephrology research network

Principal investigator:

Stroke prophylaxis with apixaban in patients with atrial fibrillation and CKD stage 5 (SACK) - an international multicentre open label blinded endpoint phase 3b randomized controlled trial (ongoing, recruiting)

Swedish Renal Registry - Chronic Kidney Disease - a real world national CKD registry of nephrology-referred patients 2008 - ongoing

Co-principal investigator: 

RENAL-QS - an observational, prospective cohort study of patients with severely decreased GFR, including clinical data, laboratory measurements, PROMS, and treatment satisafction, and biobank collection

National coordinator: 

The European Quality in CKD (EQUAL) study - an European multicentre observational study of older adults with incident eGFR<20 ml/min/1.73m, including prospective information on routine lab, clinical data, PROMs, and biobank collection

Funding: Swedish Research Council, Heart & Lung foundation, Njurfonden, Stig & Gunborg Westman Foundation; ALF Medine (Region Stockholm), Högre klinisk forskare (Region Stockholm); Industry collaborative research grants

I am a clinician-scientist with a long-standing commitment to advancing nephrology, with particular focus on chronic kidney disease (CKD) epidemiology, biomarker discovery, and clinical trials. My academic profile spans both translational and population-level research, supported by a strong methodological foundation in clinical epidemiology, biostatistics, bioinformatics, and randomized controlled trials (RCTs). My research approach consistently integrates real-world data and registry-based analyses with advanced statistical methods and causal inference techniques. My main research line is in clinical epidemiology and nephrology, divided into four different interest areas described below.

Clinical Epidemiology in CKD

The core focus of my research lies in the study of CKD progression and outcomes. Our group has explored predictors of cardiovascular morbidity, mortality, and renal function decline in patients with stages 3–5 CKD. The focus has been to apply real-world registry data, particularly from the Swedish Renal Registry (SRR-CKD), to assess the influence of various etiologic and prognostic factors, such as sex, comorbidity status, glomerular diseases, covid-19, and body composition on the risk for adverse outcomes. My research has also involved non-pharmacological treatments such timing of dialysis initiation, vascular access, dialysis modality selection and outcomes, shared desicion-making and treatment satisfaction, with a strong focus on patient-centered care. 

A part of this program is to implement a new digital application for symptom reporting through the national electronic health systems (1177). The research combines both quantitative and qualitative methods to study the implementation of the digital application in Region Stockholm in terms of dissemination, and patient and care-provider effects. We are also integrating risk prediction equations into electronic health systems, investigating their effect as decision support tools. 

Cardio-kidney-metabolic research

Using rich, longitudinal data from over 60, 000 patients in the Swedish Renal Registry, I lead the following research projects:

• Cardio-renal-metabolic syndrome: Investigating how target achievement for systolic blood pressure, HbA1c, and cholesterol/LDL affects cardiovascular outcomes and kidney disease progression in CKD stages 3–5.
• Real-world effectiveness and safety of new cardio-renal-metabolic medications: Using target trial emulation strategy to assess the safety and efficacy of SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists (nsMRAs), GLP-1 receptor agonists in non-dialysis CKD and kidney transplanted patients.
• Heart failure and atrial fibrillation: Using echocardiographic data from Region Stockholm (>3000 patients) linked to the SRR to explore prevalence, incidence, and progression of heart failure subtypes and atrial fibrillation in CKD patients and its relevance to future outcomes.

Clinical trials

I am the coordinating and principal investigator of Stroke prophylaxis with apixaban in patients with atrial fibrillation and CKD stage 5 (SACK). In this international, multicentre phase 3b trial with more than 35 sites across Sweden, Finland, Norway, Iceland, Poland, and the Netherlands we randomize patients with CKD stage 5 to standard of care without oral anticoagulation or with low dose apixaban 2.5 mg x 2. The study started in February 2022 and is planned to recruit 1000-1400 patients until December 2027. We expect to have the results by the end of 2028. 

I am also involved as a co-investigator in the INITIATE trial, the first RCT conducted through our national Swedish research network in nephrology.  This trial ended in 2024 and investigate the effect of broccoli-sprout extract on metabolic control in patients with CKD stage 3b-4. The next planned RCT through the network is the effect of SGLT2-inhibitors on cardiovascular disease outcomes in patients with CKD on maintenance dialysis. 

Biomarkers and uremic toxins in CKD PROM 

In this translational research project, we plan to identify novel biomarkers and molecular pathways underlying the development of uremic symptoms—such as pruritus, restless legs, sexual dysfunction, and cognitive impairment—in patients with advanced CKD. By linking molecular profiles to longitudinal symptom trajectories and clinical outcomes, including cardiovascular events and mortality, the project seeks to uncover new therapeutic targets for personalized treatment. The project’s design, which combines longitudinal phenotyping with multi-omics and machine learning, reflects a precision medicine approach.  

Lecturer & Team leader/Facilitator for Team-based learning in Medical Programme, course Medicine, Karolinska Institutet

Development of TBL learning objectives and learning outcomes for the nephrology part of the Medical Programme, course in Medicine, Karolinska Institutet. My role was to be part of the group of nephrologists at Karolinska and Danderyd hospital who proposed and developed the learning objectives and outcomes at Karolinska Institutet, 2023.

Clinical representative for Research, development, and education, first, second and third cycle, 2019-ongoing at Karolinska University hospital nephrology unit (USV).

Course leader and co-leader, 2015-ongoing, third cycle, General nephrology (for primary care physicians, geriatricians, and internal medicine physicians), Karolinska Institutet (IPULS - certified).

Lecturing & Seminar leader in several postgraduate courses in nephrology (different focus), Karolinska Institutet and Gothenburg University

Lecturing about nephrology for primary health care physicians, through the nephrology expert council and Region Stockholm

Course assistant, 2007-2009, first cycle Medicine, Medical programme Huddinge, Karolinska Institutet

Invited speaker at numerous ERA congresses, postgraduate education courses, national nephrology meetings, and Nordic nephrology meetings