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Research Topics

Kidney disease is complex. There are several sub-categories of kidney disease with various causes, symptoms, treatments and outcomes. BC kidney care professionals – and patient partners who are increasingly part of research teams - address a number of research and quality improvement questions. Click on the topics below to learn more about the kinds of questions being explored.

There is a wide range of potential causes of kidney disease, including diabetes, high blood pressure, genetic conditions, or medications that can damage the kidneys. Once kidney disease occurs, it is irreversible, which is why prevention and early detection is essential. For these reasons, BC clinicians conduct research to support earlier detection of kidney disease (e.g., through blood and urine tests) and to study the effects of medications and diseases that affect kidney biology. 

 

Often BC research studies focus on understanding the biology of kidney disease to better understand the fundamentals of living with it. Other focuses include finding new treatments and disease management strategies. Findings support changes in practice that may delay the decline of kidney function and decrease the risk of secondary complications associated with kidney disease. Diet, medications, and new blood tests are investigated to come up with the best strategy to help patients manage their disease.

Glomerulonephritis (GN) is a group of kidney diseases that, while relatively rare, represent the second most common cause of end-stage renal disease (kidney failure) in Canada. GN appears to be increasing in prevalence and disproportionately affecting younger Canadians. Along with our GN Network and Registry and international collaborators, our research aims to identify risks and address gaps and barriers to best care for GN patients. 

Dialysis is currently the most common form of treatment for people with advanced kidney disease. It can be done in variety of ways (hemodialysis in a hospital unit, community unit or at home, and home-based peritoneal dialysis) using different kinds of medical machines and resources. Our research strives to improve the symptoms and quality of life associated with dialysis, as well as minimize the risk of negative outcomes for patients who rely on this form of treatment.  

 

Kidney transplant research in BC – which is facilitated and supported by BC Transplant and the Transplant Research Foundation of BC – has various aims:

  • to prolong the life of the recipient and the implanted kidney
  • to balance the risks and benefits of treatments and procedures
  • to increase organ donation rates
  • to improve strategies for matching recipients and donors, and
  • to test immunosuppressive medications.

Palliative care research, evaluation and quality improvement in BC supports the implementation of a provincial palliative care strategy. BC Renal, in close collaboration with palliative care colleagues and programs in the regional health authorities, both supports and applies knowledge from studies and initiatives to improve palliative care practices and experiences for our province's patients and health professionals. 

The Can-SOLVE CKD Network (Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease) is a pan-Canadian research network that is taking a patient-oriented approach that aims to greatly improve patient care, outcomes and opportunities to participate in studies. A BC scientific and administrative team is co-leading the network, and BC Renal is key partner, supporting a number of the network's initiatives. Learn more from the network's website.

 


About


Publications and Presentations


Publications

  1. Genga KR, Lo C, Cirstea M, Zhou G, Walley KR, Russell JA, Levin A, Boyd JH. (2017). Two-year follow-up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate. Journal of Internal Medicine. 281(5):518-529.
  2. Sawhney S, Levin A, Black C. (2017). In Reply to 'Long-term Outcomes of Survivors of Acute Kidney Injury Stage 3'. American Journal of Kidney Diseases. 69(5):705-706.
  3. Sawhney S, Marks A, Fluck N, Levin A, Prescott G, Black C. (2017). Intermediate and Long-term Outcomes of Survivors of Acute Kidney Injury Episodes: A Large Population-Based Cohort Study. American Journal of Kidney Diseases. 69(1):18-28.
  4. Sawhney S, Marks A, Fluck N, Levin A, McLernon D, Prescott G, Black C. (2017). Post-discharge kidney function is associated with subsequent ten-year renal progression risk among survivors of acute kidney injury. Kidney Int. 92(2):440-452.
  1. Guillemi SA, Ling SH, Dahlby JS, Yip B, Zhang W, Hull MW, Lima VD, Hogg RS, Werb R, Montaner JS, Harris M. (2016). Effects of a switch from tenofovir- to abacavir-based antiretroviral therapy, with or without atazanavir, on renal function. Journal of the international aids society.19:6.
  2. Romanowski K, Clark EG, Levin A, Cook VJ, Johnston JC. (2016).Tuberculosis and chronic kidney disease: an emerging global syndemic. Kidney international. 90(1):34-40.
  3. Sawhney S, Fluck N, Levin A, Macleod A, Marks A, Prescott G, Black C. (2016). Long-term prognosis of acute kidney injury: a 10 year population-based study. Lancet. 387:89-89.
  4. Wilson M, Mazowita G, Ignaszewski A, Levin A, Barber C, Thompson D, Barr S, Lear S, Levy RD. (2016). Family physician access to specialist advice by telephone reduction in unnecessary specialist consultations and emergency department visits. Canadian family physician. 62(11):E668-E676.
  1. Aeng, ESY, Shalansky, KF, Lau, TTY, Zalunardo, N, Li, GY, Bowie, WR, Duncan, CP. (2015). Acute Kidney Injury With Tobramycin-Impregnated Bone Cement Spacers in Prosthetic Joint Infections. Annals of Pharmacotherapy, 49(11), 1207-1213.
  2. Graziani MS, Plebani M. (2015). The standardization of the urine albumin assays: no longer deferrable. Clinical Chemistry and Laboratory Medicine (CCLM). 53(11):1657-9.
  3. Hemmett J, Er L, Chiu HH, Cheung C, Djurdjev O, Levin A. (2015). Time to revisit the problem of CIN? The low incidence of acute kidney injury with and without contrast in hospitalized patients: an observational cohort study. Canadian journal of kidney health and disease. 2(1):1-8.
  4. Jacobson BE, Seccombe DW, Katayev A, Levin A. (2015). A study examining the bias of albumin and albumin/creatinine ratio measurements in urine. Clinical Chemistry and Laboratory Medicine (CCLM). 2015 Mar 28
 
  1. Chau, K, Schisler, T, Er, L, Jaswal, D, Cheung, C, Israel, A, Bowering, J, Levin, A. (2014). Fluid balance, change in serum creatinine  ,urine output as markers of acute kidney injury post cardiac surgery: an observational study. Can J Kidney Health Dis, 1, 19.
  2. Grunau BE, Pourvali R, Wiens MO, Levin A, Li J, Grafstein E, Joo D, Scheuermeyer FX. (2014). Characteristics and Thirty‐day Outcomes of Emergency Department Patients With Elevated Creatine Kinase. Academic Emergency Medicine. 21(6):631-6.
  3. Hutton, HL, DeMarco, ML, Magil, AB, Taylor, P. (2014). Renal Leukocyte Chemotactic Factor 2 (LECT2) Amyloidosis in First Nations People in Northern British Columbia, Canada: A Report of 4 Cases. American Journal of Kidney Diseases. (645): 790-792.
  4. Kendrick JG, Ensom MHH, Steer A, White CT, Kwan E, Carr RR. Standard-Dose Versus High-Dose Acyclovir in Children Treated Empirically for Encephalitis: A Retrospective Cohort Study of Its Use and Safety. Pediatric Drugs. Volume 16, Number 3 (2014): Pages 229-234
  5. Levin A, Remuzzi G. (2014). Clinical trials: ISN-ACCTS: global initiatives to improve clinical research. Nature Reviews Nephrology. 2014 Aug 1;10(8):426-7.
  6. Levin A. (2014). Commentary on “Kidney disease guideline profusion and confusion:  unintended consequences of different perspectives and definitions”, AJKD, May 2014; Vol 63, Issue 5, pp 749-52
  7. Levin, A, Remuzzi, G. (2014). CLINICAL TRIALS ISN-ACCTS: global initiatives to improve clinical research. Nature Reviews Nephrology, 10(8), 426-427.
  8. Levin, A, Stevens, PE, Coresh, J, Levey, A. (2014). Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease. Annals of Internal Medicine, 161(1), 81-82.
  9. Linder, A, Fjell, C, Levin, A, Walley, KR, Russell, JA, Boyd, JH. (2014). Small Acute Increases in Serum Creatinine Are Associated with Decreased Long-Term Survival in the Critically Ill. American Journal of Respiratory and Critical Care Medicine. 189(9): 1075-1081.
  10. Misra, S, Gupta, A, Symes, A, Duncan, J. (2014). Haemophagocytic syndrome after intravesical bacille Calmette-Guerin instillation. Scandinavian Journal of Urology, 48(3), 328-330
  1. AlAbbas A, Campbell AI, Skippen P, Human D, Matsell DG,Mammen C. Epidemiology of cardiac surgery associated acute kidney injury in neonates: A retrospective study. Pediatric Nephrology. 28:1127-34.
  2. Coresh J, Levey AS, Levin A, Stevens P. (2013). A stable definition of chronic kidney disease improves knowledge and patient care. BMJ. 347.
  3. Eckardt, KU, Coresh, J, Devuyst, O, Johnson, RJ, Kottgen, A, Levey, AS, Levin, A. (2013). Evolving importance of kidney disease: from subspecialty to global health burden. Lancet. 382(9887) 158-169.
  4. Imani PD, Odiit A, Hingorani SR, Weiss NS, Eddy AA. Acute kidney injury and its association with in-hospital mortality among children with acute infections. Pediatr Nephrol. 28:2199-2206.
  5. Lafrance, JP, Levin, A. (2013). Defining AKI: closer to getting the math right. Nephrology Dialysis Transplantation, 28(6), 1340-1342.
  6. Levey, AS, Levin, A, Kellum, JA. (2013). Definition and Classification of Kidney Diseases. American Journal of Kidney Diseases, 61(5), 686-688.
  7. Levin, A, Lancashire, W, Fassett, RG. (2013). Targets, trends, excesses,  ,deficiencies: refocusing clinical investigation to improve patient outcomes. Kidney International, 83(6), 1001-1009.
  8. Levin, A, Perkovic, V. (2013). EPIDEMIOLOGY Global Burden of Disease Study 2010: implications for nephrology. Nature Reviews Nephrology, 9(4), 195-197.(6), 1001-1009
 
  1. Bagshaw S, Wald R, Barton J, Burns K, Friedrich J, House A, James M, Levin A, Moist L, Pannu N, Stollery D, Walsh M. Clinical factors associated with inititation of renal replacement therapy in critically ill patients with Acute Kidney Injury – a prospective multi-centre observational study journal of critical care. Journal of Critical Care. June 2012; 27(3):268-75.
  2. Iosfina J, Lan J, Chan C, Levin A. Massive Colchicine Overdose with Recovery.Case Reports in Nephrology and Urology, Jan-Jun 2012; 2:20-4.
  3. Levin A. (2012). Year in Review 2011 - Progression, prediction, populations and possibilities. Nature Reviews Nephrology, Feb 2012; 8(2)70-2.  
  4. Molitoris B, Okusa M, Palevsky P, Chawla L, Kaufman J, Devarajan P, Toto R, Hsu C-Y, Greene T, Faubel S, Kellum J, Wald R, Chertow G, Levin A, et al. Design of Clinical Trials in Acute Kidney Injury: A Report from an NIDDK Workshop. Trials of patients with sepsis and in selected hospital settings. CJASN May 2012; 7(5):856-60.
  5. Okusa M, Molitoris B, Palevsky P, Chinchilli V, Liu K, Cheung A, Weisbord D, Faubel S, Kellum J, Wald R, Chertow G, Levin A et al. Design of clinical trials in Acute Kidney Injury: a Report from an NIDDK Workshop-Prevention Trials. CJASN May 2012; 7(5):851-5.
  6. Palevsky P, Molitoris B, Okusa M, Faubel S, Kellum J, Wald R, Chertow G, Levin A, et al. Design of Clinical Trials in Acute Kidney Injury: Report from an NIDDK Workshop on Trial Methodology. CJASN May 2012; 7(5):844-50.
  7. Trnka P, Hiatt MJ, Tarantal AF, Matsell DG. (2012). Congenital urinary tract obstruction: defining markers of developmental kidney injury. Pediatric Research. 72:446-454.  
  8. Trnka P, Ivanova L, Hiatt MJ, Milner R, Matsell DG. Urinary biomarkers in obstructive nephropathy.Clinical Journal of the American Society of Nephrology. 7:1567-1575
 
 
  1. Negash DT, Dhingra VK, Copland M, Griesdale D, Henderson W. Intensity of continuous renal replacement therapy in acute kidney injury in the intensive care unit: a systematic review and meta-analysis. Vascular and Endovascular Surgery. 2011 Aug; 45(6):504-10.
  2. Prestidge C, Rassekh SR, Matsell DG. Nephrotic syndrome developing during induction chemotherapy for childhood acute lymphoblastic leukemia. Clinical and Experimental Nephrology. 2011 Jun; 15(3):410-3
  1. Jia Y, Sun YH, House JD, Ogborn MR, Weiler HA, O K, Aukema HM. Long-term intake of whole proteins results in renal damage in the pig model. J Nutr. 140(9):1646-52, 2010.
  2. Levin A. (2010). Health care reform, US and Canada: Musings as to myths and caveats. Renal and Urology News. June 2010.
  3. Trnka P, Hiatt MJ, Ivanova L, Tarantal AF, Matsell DG. (2010). Phenotypic transition of the collecting duct epithelium in congenital urinary tract obstruction. Journal of Biomedicine and Biotechnology. 2010:696034. 
  4. Warnock DG, Remuzzi G, Brenner BM, Levin A, Wanner C. (2010). Introduction to focus on Fabry nephropathy: Biomarkers, progression, and disease severity. Clinical Journal of the American Society of Nephrology. 5(2):359
 

Presentations

 
  1. Improving Access to Specialist Care in Rural Communities 
    Team: Brian Forzley, Ella Monro, Lisa Needoba (Interior Health)
 
  1. Contrast Induced Nephropathy: Assessing the True Incidence of AKI Related to CT Scans with and without Contrast
    Organizations: University of Alberta; University of British Columbia; University of Calgary; Université de Picardie; Mario Negri Institute.
    Team: St. Paul's Hospital; University of British Columbia; BC Provincial Renal Agency; Vancouver Coastal Health Authority.
  2. Development, Implementation and Evaluation of a Web-Based Clinical Pathway for Chronic Kidney Disease in Primary Care
    Organizations: University of Calgary; University of Alberta; University of British Columbia; Alberta Health Services
    Team: Maoliosa Donald, Braden Manns, Marcello Tonelli, Kailash Jindal, Nairne Scott-Douglas, Adeera Levin, Tom Noseworthy, Richard Lewanczukesdy
  3. Renal Replacement Therapy Following Pediatric Cardiac Surgery: A Local Review of Outcomes and Renal Recovery
    Organization: University of British ColumbiaTeam: Nicholas Larkins, Peter Skippen, Gordon Krahn, Sanjiv Gandhi, Andrew Campbell, Cherry Mammen
  1.  The British Columbia Nephrologists’ Access Study (BCNAS) - Waiting for Initial Specialist Assessment of Chronic Disease: A Systematic Approach to Developing Benchmarks
    Organization: BC Renal Agency and Division of Nephrology, University of British Columbia
    Team: Michael E. Schachter, Alexandra Romann; Ognjenka Djurdjev; Adeera Levin; Monica Beaulieu 

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