Andrew House

Andrew House

In this study, researchers tracked over 300 high-risk kidney transplant recipients across seven Canadian centres to evaluate how cytomegalovirus is managed during the first year after surgery. Although all patients received preventative antiviral medication, one-third still developed the virus, and many experienced complications such as low blood cell counts, other infections, or the need for hospitalisation. These findings highlight that current prevention strategies are often insufficient for high-risk patients and are frequently associated with significant side effects and healthcare costs.

Andrew House

This study examined a specific type of kidney cancer characterized by a fibrous, muscular structure in three patients with tuberous sclerosis complex, a genetic condition. Researchers discovered that these tumours can contain areas that look like a different type of growth called a hemangioblastoma, but they share the same underlying genetic markers related to the tuberous sclerosis pathway. Identifying this unique appearance is important for doctors to ensure patients receive an accurate diagnosis and appropriate monitoring, as these specific tumours appear to grow slowly and behave less aggressively.

Louise MoistDervla ConnaughtonMatthew WeirSusan HuangAndrew HouseLakshman GunaratnamArsh JainAmit GargAndrea CowanPavel RoshanovPeter Blake

In a study of 125 adults aged 50 and older with chronic kidney disease, researchers found that genetic testing identified a specific cause of disease in 38% of patients. The highest success rate for diagnosis occurred in those aged 50 to 54, with various forms of glomerular disease being the most common findings. These genetic results led to changes in medical treatment and clinical management, suggesting that age alone should not be a barrier to accessing genetic testing for kidney disease.

Andrew House

This study reviewed the medical investigations performed for children with tuberous sclerosis complex who were referred to a specialized clinic at a Canadian hospital. Researchers identified gaps in the recommended health monitoring and surveillance for these patients, highlighting areas where care could be improved.

Andrew House

In this study, researchers examined blood markers of inflammation and brain cell injury in adults with tuberous sclerosis complex to identify indicators of disease activity. They found that patients with this genetic condition had higher levels of specific inflammatory proteins and markers of brain cell activation compared to healthy individuals, with certain proteins specifically linked to active epilepsy and the presence of kidney tumours. These findings suggest that these blood markers could eventually help clinicians monitor disease progression and identify new targets for treating complications like seizures and kidney growths.

Louise MoistDervla ConnaughtonMatthew WeirAndrew HouseLakshman GunaratnamArsh JainAndrea CowanPavel Roshanov

Researchers evaluated the impact of a specialized kidney genetics clinic in Canada by providing genetic testing to 300 patients with chronic kidney disease who met specific referral criteria. The study found that using a standardized testing process identified a genetic cause for kidney disease in one-third of the families, with results typically delivered within three months of assessment. These genetic findings frequently led to changes in clinical management, though the researchers noted a significant delay of over ten years between a patient's initial kidney disease diagnosis and their eventual genetic evaluation.

Dervla ConnaughtonMatthew WeirSusan HuangAndrew HouseLakshman GunaratnamPavel Roshanov

Researchers analyzed genetic data from patients with chronic kidney disease to investigate why many develop severe hardening of the arteries, known as vascular calcification. They identified specific mutations in the ABCC6 gene in several families, suggesting that inherited genetic factors may directly contribute to this cardiovascular complication. Identifying these genetic causes early could eventually help doctors use targeted therapies to prevent vascular damage and reduce the risk of death in kidney disease patients.

Matthew WeirAndrew House

Researchers compared the success of kidney transplants from older or higher-risk donors based on whether the organ was donated after circulatory death or brain death. They found that kidneys donated after circulatory death had significantly higher rates of initial function delay and a higher risk of graft failure within the first three years. Despite these differences in organ survival, there was no significant difference in overall patient survival between the two groups.

Andrew HousePavel Roshanov

Researchers evaluated a shortened two-hour monitoring protocol for patients undergoing kidney biopsies at a Canadian hospital and found that all major bleeding complications were identified within that timeframe. The study also tested a risk calculator designed to predict bleeding, which showed high accuracy in identifying high-risk patients despite the low overall number of complications. These findings suggest that a brief observation period combined with routine ultrasound is sufficient for safely managing patients after a kidney biopsy.

Andrew House

This report describes two cases where patients with tuberous sclerosis complex experienced declining kidney function due to microscopic disease rather than the large kidney tumours typically associated with the condition. The authors provide evidence that medications known as mTOR inhibitors may help improve kidney function in these patients even when large tumours are absent. The findings suggest that doctors should regularly monitor kidney function in all patients with this genetic condition and consider a kidney biopsy if the cause of decline is unclear.

Andrew House

This review examines the evidence for using medical therapies to manage coronary artery disease in people with chronic kidney disease and those receiving dialysis. The authors highlight that while standard treatments like aspirin and statins are commonly used, their effectiveness may decrease as kidney function declines, and patients face a higher risk of side effects. The paper also discusses newer medications, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, which show potential for reducing heart-related complications in this population.

Andrew House

Researchers tracked over 1,100 critically ill patients across five academic centres to understand the patterns and outcomes of continuous kidney replacement therapy for acute kidney injury. The study found that while sepsis was the most common cause of kidney injury and fluid overload was a primary reason for starting treatment, there was significant variation in medical practice between different hospitals. Only about 41 percent of patients survived to hospital discharge, with older age and higher severity of illness being major factors linked to lower survival rates.

Andrew HouseLakshman Gunaratnam

Researchers at a Canadian transplant centre found that kidney transplant recipients who experienced delayed graft function were more likely to develop late-onset cytomegalovirus infections. These infections significantly increased the risk of transplant failure, particularly in patients whose new kidney did not function immediately after surgery. The study suggests that closer monitoring of immune responses to the virus might help improve long-term outcomes for these high-risk patients.

Matthew WeirAndrew HouseAmit GargBrad Urquhart

Researchers developed a new laboratory test to measure a molecule called TMAP in the blood and evaluated its potential as a marker for kidney function across several patient groups. The study found that TMAP levels were significantly higher in patients with chronic kidney disease and those receiving dialysis compared to healthy individuals, with levels rising as the kidney's filtering capacity declined. Because TMAP was also found in other species and even in maple tree sap, it appears to be part of a biological process that is widely conserved across nature.

Christopher McIntyreAndrew House

Midodrine is an effective therapy for managing low blood pressure during hemodialysis treatments when other standard interventions have failed. This publication argues in favour of its use, highlighting its role in improving patient stability and ensuring the completion of necessary dialysis sessions.

Christopher McIntyreAndrew House

This study evaluated the safety and feasibility of a new blood-filtering treatment called leucocyte modulation, which aims to reduce the harmful immune system overactivity seen in severe COVID-19 infections. Researchers found that the treatment was safe for critically ill patients on mechanical ventilation and was associated with a significant reduction in the dose of blood-pressure-supporting medications required. While the results are promising, the study was a small preliminary evaluation intended to support the design of larger trials to determine the best way to use this therapy.

Christopher McIntyreAndrew House

Researchers in Ontario used a participatory photography method called Photovoice to explore resilience and quality of life among adults receiving long-term hemodialysis. Participants used various camera technologies to document their daily lives and led focus groups to determine how their images and personal stories should be shared with the public. This collaborative approach aims to empower patients as community informants and develop new ways to raise awareness about living with chronic kidney disease.

Andrew House

This study followed over 200 Canadian patients who returned to dialysis after a kidney transplant failed to determine how their ongoing use of anti-rejection medications affected their health. Researchers found that patients who continued taking immunosuppressants had a lower risk of death compared to those who stopped the medications or took only prednisone, without experiencing a significant increase in hospitalizations for infections. While continuing these medications did not prevent the development of antibodies that could complicate future transplants, the findings suggest that maintaining some immunosuppression after transplant failure may offer survival benefits.

Christopher McIntyreAndrew House

Researchers used a specialized type of imaging called sodium magnetic resonance imaging to measure the salt gradient between the inner and outer parts of the kidney in healthy volunteers and patients with chronic kidney disease. The study found that this imaging technique accurately tracked changes in kidney salt levels following a water load and matched results from traditional urine tests. This technology provides a non-invasive way to assess kidney concentration ability and could be a feasible tool for monitoring patients with reduced kidney function.