Research Publications

Recently published research from the Division of Nephrology.


QALYs, DALYs and Now PALYs: Strengthening the Argument for Prevention of CKD

An editorial in the Journal of the American Society of Nephrology by Mark Canney and Adeera Levin about strengthening the argument for prevention of CKD. Read more...


Insights from CREDENCE trial indicate an acute drop in estimated glomerular filtration rate during treatment with canagliflozin with implications for clinical practice

Kidney International Published: December 11, 2020 DOI: https://doi.org/10.1016/j.kint.2020.10.042 Megumi Oshima, Meg J. Jardine, Rajiv Agarwal, George Bakris, Christopher P. Cannon, David M. Charytan, Dick de Zeeuw, Robert Edwards, Tom Greene, Adeera Levin, Soo Kun Lim, Kenneth W. Mahaffey, Bruce Neal, Carol Pollock, Norman Rosenthal, David C. Wheeler, Hong Zhang, Bernard Zinman, Vlado Perkovic and Hiddo J.L. Heerspink Canagliflozin […] Read more...


Adapting Nephrology Training Curriculum in the Era of COVID-19

The COVID-19 pandemic has widespread implications not only for clinical practice but also for academic medicine and postgraduate training. The need to promote physical distancing and flexibility within our department has generated important revisions to the core curriculum for the Adult Nephrology Training Program in Vancouver, Canada. We reviewed available educational resources and objectives to develop curricular adaptations informed by staff and trainee feedback. We describe existing changes to formal training in British Columbia (BC), which will be tailored as the pandemic evolves, and anticipate them to have lasting impact on the way we structure training programs in the future. Standardization and harmonization of modified curriculum may be possible across Canada with sharing of these learnings. Read more...


Passage of the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act—a Chance to Celebrate and Reflect

The Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act (H.R. 5534; also known as the Immuno bill) in the United States, will add a new Medicare option solely to cover immunosuppressive drugs for kidney transplant recipients. An analysis by the Department of Health and Human Services (HHS) estimated that the Immuno bill will prevent approximately 375 allograft failures annually, and the Congressional Budget Office (CBO) projects Medicare savings of $400 million over 10 years. Legislation proposing extension of immunosuppressive drug coverage have been introduced in Congress for the past two decades, and the passage of the Immuno bill represents a huge victory for current and future transplant recipients. Read more...


Technique Survival and Determinants of Technique Failure in In-Center Nocturnal Hemodialysis: A Retrospective Observational Study

Long-duration (7-8 hours) hemodialysis provides benefits compared with conventional thrice-weekly, 4-hour sessions. Nurse-administered, in-center nocturnal hemodialysis (INHD) may expand the population to whom an intensive dialysis schedule can be offered. INHD is a sustainable modality, even among older patients. Higher frailty associates with INHD technique failure and greater missed treatments. Inclusion of a CFS threshold of ≤4 into INHD inclusion criteria may help to identify individuals most likely to realize the long-term benefits of INHD. Read more...


Performance of StatSensor Point-of-Care Device for Measuring Creatinine in Patients With Chronic Kidney Disease and Postkidney Transplantation

The StatSensor is a point-of-care device which measures creatinine in capillary whole blood. Previous studies reported an underestimation of the creatinine measurements at high creatinine concentrations and were performed in the prestandardization era for creatinine. The results of our study suggest that the limiting characteristics of the StatSensor device are not only bias, but also imprecision. The level of imprecision observed may influence clinical decision-making and limit the usefulness of StatSensor as a CKD screening tool. If choosing to utilize it for either screening for or monitoring CKD, it is essential that clinicians understand the limitations of point-of-care devices and apply this knowledge to test interpretation. Read more...


Pretransplant Calculated Panel Reactive Antibody in the Absence of Donor-Specific Antibody and Kidney Allograft Survival

Panel reactive antibody informs the likelihood of finding an HLA-compatible donor for transplant candidates, but has historically been associated with acute rejection and allograft survival because testing methods could not exclude the presence of concomitant donor-specific antibodies. Despite new methods to exclude donor-specific antibodies, panel reactive antibody continues to be used to determine the choice of induction and maintenance immunosuppression. The study objective was to determine the clinical relevance of panel reactive antibody in the absence of donor-specific antibodies. Read more...


A Framework to Ensure Patient Partners Have Equal and Contributing Voices Throughout the Research Program Evaluation Process

Traditionally, peer review was a closed process conducted only by individuals working in the research field. To establish a more integrated and patient-centered approach, one of Canada’s largest kidney research networks (Can-SOLVE CKD) has created a Research Operations Committee (ROC) that includes patients as key members. The ROC represents one way for achieving meaningful patient-oriented research (POR). Read more...


Management of Patients With Glomerulonephritis During the COVID-19 Pandemic: Recommendations From the Canadian Society of Nephrology COVID-19 Rapid Response Team

Kidney programs across Canada face challenges delivering care during the COVID-19 pandemic. Chronic kidney disease (CKD) and preexisting autoimmune diseases may increase the risk of COVID-19-related complications. In addition, physical distancing has impacted the ways in which health care providers deliver care. This document provides suggestions on how to provide the best possible care for patients living with GN during the COVID-19 pandemic. Patients with GN have health care needs that differ from those of patients with other forms of kidney disease, including CKD, end-stage kidney disease including transplantation. The care of other patients with kidney disease, including those with less advanced forms of CKD, is outside the scope of this document. Read more...


Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide

People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality. Read more...


 

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