Andrew House

Andrew House

Researchers compared two intensive care registries of critically ill patients with cirrhosis or sudden worsening of chronic liver failure who needed continuous treatment to replace kidney function. Only about one-third survived to hospital discharge; among survivors, nearly two-thirds were switched to intermittent hemodialysis, and higher prescribed treatment doses were associated with higher in-hospital mortality. Treatment to prevent clotting with regional citrate was commonly used despite concerns about its safety.

Matthew WeirAndrew HousePavel Roshanov

Researchers tested a risk calculator designed to predict major bleeding complications after a kidney biopsy by applying it to a group of patients in Nova Scotia. The calculator, which uses factors like age, weight, and blood counts, accurately identified patients at higher risk for serious bleeding events such as the need for a blood transfusion. These findings suggest the tool can help doctors and patients better assess individual risks and plan for appropriate monitoring after the procedure.

Andrew House

This study examined the relationship between obesity and in-hospital mortality among critically ill patients with acute kidney injury receiving continuous renal replacement therapy. Researchers found that obesity was independently associated with a higher risk of death, and that higher prescribed therapy doses were consistently linked to increased mortality regardless of the body weight calculation method used. These findings suggest that current treatment prescription practices may need to be tailored differently for obese patients in intensive care.

Dervla ConnaughtonMatthew WeirAndrew HouseLakshman GunaratnamAmit GargPavel Roshanov

Researchers used genetic testing to identify the underlying cause of kidney failure in nearly one-quarter of transplant recipients, often leading to a reclassification of their original diagnosis. The study also found that while only four percent of healthy prospective living donors carried high-risk genetic variants, nearly twenty percent of donors who later developed kidney complications carried these variants. These findings suggest that targeted genetic testing could improve the safety of living kidney donation by better identifying high-risk donors.

Andrew House

This publication features the cover image for an article describing a specific type of renal cell carcinoma with fibromyomatous stroma and hemangioblastoma-like areas. This tumor type is recognized as part of the disease spectrum in patients with tuberous sclerosis complex.

Andrew House

Using data from a multicentre registry, researchers evaluated continuous kidney replacement therapy dosing practices in critically ill patients. They found that only about twenty-three percent of patients were initially prescribed the guideline-recommended dose, with higher doses frequently prescribed to patients with lower body mass index, severe fluid overload, or specific chemical imbalances. Notably, receiving a higher average prescribed dose was associated with an increased risk of dying in the hospital.

Andrew House

This study examined cytomegalovirus prevention practices and infection rates among 311 high-risk kidney transplant recipients across seven Canadian centres. Despite all patients receiving antiviral preventive medication, over one-third developed cytomegalovirus infection within the first year after transplantation, with many experiencing disease symptoms or recurrent infections. Additionally, complications such as bone marrow toxicity, other opportunistic infections, and hospitalizations were common, highlighting the ongoing burden of this virus in transplant patients.

Andrew House

This study evaluated whether blood biomarkers could accurately detect the presence and size of kidney tumors, known as angiomyolipomas, in people with tuberous sclerosis complex. Researchers analyzed blood samples from two patient groups and found that measuring vascular endothelial growth factor D, especially when combined with other markers like cystatin C or neutrophil gelatinase-associated lipocalin, could accurately identify patients with large kidney tumors. These blood tests could serve as a useful screening tool to help identify patients who need closer monitoring or treatment.

Andrew House

This study examined kidney tumours from three patients with tuberous sclerosis complex, a genetic condition caused by mutations in the TSC1 gene. Researchers identified a specific type of kidney cancer, renal cell carcinoma with fibromyomatous stroma, that also displayed features resembling another rare tumour called hemangioblastoma. Despite these complex features, all patients experienced a mild, non-aggressive disease course, helping doctors better recognize and understand this specific tumour pattern in patients with tuberous sclerosis complex.

Andrew House

Researchers developed a novel 3D-printed scaffold made of an anionic citrate-based polymer and calcium phosphate to improve bone healing. In laboratory and animal studies, this scaffold successfully bound and slowly released a bone-growth protein, promoting spinal fusion in rabbits at doses 45-fold lower than those currently used in clinical practice. This technology offers a safer and more controlled approach for delivering bone-healing proteins in complex reconstructive surgeries.

Andrew House

This study evaluated the current state of care for patients with tuberous sclerosis complex across Canada. The findings highlight significant variations in access to specialized care, surveillance monitoring, and treatment options among different provinces. Improving coordination and establishing standardized clinics could help address these disparities in care delivery.

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

Researchers developed a novel biomaterial platform that allows precise control over cellular alignment and matrix stiffness. Using this system, they demonstrated how heart muscle cells derived from human induced pluripotent stem cells adapt to changes in their physical environment. This platform provides new insights into cellular-microenvironment interactions to help advance cardiac tissue engineering.

Andrew House

This study examined blood biomarkers in individuals with tuberous sclerosis complex, a genetic disorder that can cause epilepsy and kidney tumors. Researchers found that patients with tuberous sclerosis complex had elevated levels of specific inflammatory proteins and markers of brain cell activation compared to healthy controls. Notably, higher levels of these inflammatory markers were associated with active epilepsy and the presence of kidney angiomyolipomas, suggesting they could serve as useful biomarkers or treatment targets.

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.

Andrew House

Researchers developed a dynamic biomaterial platform that can change its stiffness and surface patterns to study how human heart muscle cells respond to tissue changes. They found that culturing these cells on healthy, flexible matrices significantly improved their structure and beating function compared to stiffer, fibrotic matrices. Conversely, exposing the cells to dynamic matrix stiffening, mimicking the scarring process seen in heart disease, negatively impacted their function, particularly when the stiffening occurred early in development.

Andrew House

Researchers developed and validated a clinical risk score to predict the development of kidney and lung tumours in individuals with tuberous sclerosis complex, an inherited genetic condition. Using data from a large natural history database, the risk scores demonstrated strong accuracy in predicting the presence, location, and size of these tumours based on early-onset clinical features, sex, and genetic mutations. These findings could help clinicians personalise screening schedules and preventative care for patients with tuberous sclerosis complex.

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.

Andrew House

This study analyzed national Medicaid claims data from 2006 to 2018 to evaluate pregnancy outcomes in individuals with sickle cell disease. Researchers found that pregnancy-related complications, including preeclampsia, hypertension, and maternal death, were significantly more common in people with sickle cell disease compared to those without the condition. Furthermore, these serious complications did not improve over the twelve-year study period, and some actually increased in frequency.

Matthew WeirAndrew House

A study at a single transplant centre evaluated the outcomes of kidney transplant recipients who received expanded criteria donor organs, comparing those from donors after circulatory death to those from donors after neurologic determination of death. Researchers found that recipients of kidneys from donors after circulatory death experienced significantly higher rates of delayed graft function and lower overall graft survival at one and three years post-transplant. Despite the higher rate of graft loss, there was no significant difference in patient survival between the two groups.

Andrew House

This case report describes a patient with cold agglutinin disease who developed renal iron overload, a rare complication of chronic red blood cell destruction. Treatment with the monoclonal antibody rituximab successfully managed the underlying autoimmune condition and resolved the renal iron accumulation. This highlights a potential therapeutic approach for preserving kidney function in patients experiencing severe hemolysis-associated iron overload.

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 of patients with tuberous sclerosis complex who experienced declining kidney function due to microscopic kidney disease rather than large, typical lesions like angiomyolipomas. In both cases, treatment with mammalian target of rapamycin inhibitors helped improve kidney function, suggesting this therapy may be beneficial even without large lesions. The findings highlight the importance of annual kidney function monitoring and suggest a low threshold for performing a kidney biopsy when the cause of declining kidney function is unclear.

Andrew House

Patients with chronic kidney disease face a high risk of cardiovascular disease, yet clinical trials often exclude them, leaving a gap in evidence for managing coronary artery disease in this population. This review summarizes the safety and efficacy of standard cardiac medications, noting that therapies like aspirin and statins may have reduced benefits as kidney function declines. It also highlights the potential of newer therapies, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, to lower cardiovascular risk in these patients.

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.

Andrew House

Researchers developed and internally validated a clinical risk score to predict the development of kidney and lung tumours in individuals with tuberous sclerosis complex. The tool specifically aims to estimate the risk of renal angiomyolipoma and pulmonary lymphangioleiomyomatosis in this patient population.

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.

Andrew House

This multicentre study examined the characteristics and outcomes of over 1,100 critically ill adults with acute kidney injury who required continuous kidney replacement therapy across five academic centres. Researchers found that only 41.1% of these patients survived to hospital discharge, with sepsis being the most common cause of kidney injury and fluid overload being the primary reason for starting therapy. The study revealed significant variation in patient characteristics and treatment practices among different hospitals, highlighting a need for standardized benchmarks in care delivery.

Christopher McIntyreAndrew House

This article discusses the clinical utility of midodrine, an oral medication commonly used to prevent and treat low blood pressure during hemodialysis. While small studies show midodrine effectively raises blood pressure and improves symptoms, a large observational study raised safety concerns by linking its use to higher mortality and hospitalizations. However, these observational findings may be biased by confounding, as patients prescribed midodrine are typically sicker and at higher baseline risk for poor outcomes.

Andrew House

Researchers developed a simple and robust method to create patterned elastomeric surfaces that mimic the natural structure of heart tissue. They found that the alignment of human heart muscle cells and connective tissue cells could be controlled by adjusting the dimensions of these surface patterns. This platform also allows for high-throughput screening of how cell density and different cell mixtures affect heart tissue development.

Christopher McIntyreAndrew House

This preliminary study evaluated the safety and feasibility of a novel extracorporeal immunomodulatory therapy designed to regulate white blood cells in critically ill patients with severe COVID-19. In twelve patients requiring mechanical ventilation and blood pressure support, the therapy was found to be safe and was associated with a significant 37 percent reduction in the need for blood pressure-boosting medications. These findings support further evaluation of this blood-filtering approach to manage severe inflammation in critically ill patients.

Andrew House

Using live imaging and super-resolution microscopy, researchers discovered that fibronectin fibrils, which are key components of the extracellular matrix, are not continuous fibers as previously thought. Instead, they are composed of distinct, spherical nanodomains that organize into linear, periodic arrays. This organization is blocked by a peptide that disrupts fibril formation, establishing a new model for how these structural networks assemble in tissues.

Christopher McIntyreAndrew House

The Renal Community Photo Initiative used a participatory photography method called Photovoice to explore resilience and quality of life among adult hemodialysis patients in Ontario, Canada. Participants used various photographic technologies to capture their daily lives and met in focus groups to discuss their experiences and direct how their images should be shared publicly. The project successfully gathered over 1600 images and handwritten logs, establishing a participant-led model to raise public awareness about living with chronic kidney disease.

Andrew House

This Canadian study followed patients who had to start dialysis after their kidney transplant failed to see how continuing or stopping their immunosuppressant medications affected their health. Researchers found that patients who continued taking these medications had a lower risk of death and did not experience a higher rate of hospitalizations for infections compared to those who stopped the drugs or took only prednisone. However, continuing immunosuppressants did not prevent the development of antibodies that could complicate future transplants, nor did it prevent rejection of the failed transplant.

Christopher McIntyreAndrew House

This study evaluated the ability of sodium magnetic resonance imaging to measure the sodium concentration gradient between the inner and outer parts of the kidney, which is a key indicator of kidney function. In healthy volunteers, changes in this gradient measured by the scan closely matched changes in urine concentration after drinking water, and the imaging technique was also shown to be feasible in patients with chronic kidney disease. This non-invasive imaging method could provide a new way to monitor kidney health and function without relying solely on urine tests.