Matthew Weir

Dervla ConnaughtonMatthew WeirKyla NaylorAmit Garg

Researchers in Ontario, Canada, found that men who donated a kidney through laparoscopic surgery had a significantly higher risk of requiring scrotal surgery later in life compared to men who did not donate. Over a 20-year period, nearly 14 percent of donors underwent surgery to treat fluid collection in the scrotum, most commonly a procedure called a hydrocelectomy. These findings highlight a specific long-term surgical risk for male living kidney donors that may occur several years after the initial donation.

Matthew WeirAmit Garg

Researchers in Ontario evaluated the accuracy of hospital diagnostic codes for identifying lithium toxicity by comparing them to actual blood laboratory results. The study found that while these codes were moderately effective at identifying patients with high lithium levels, they sometimes flagged patients whose levels were below the toxic threshold. These findings help clarify how reliably health database records can be used to track and study lithium-related complications in the healthcare system.

Matthew WeirAmit Garg

This is a protocol for an ongoing study that describes the design of a research project using high-performance computing to screen millions of potential drug combinations for harmful interactions in older adults. Researchers will use health records from Ontario to compare patients taking two specific medications against those taking only one, tracking over 70 different health outcomes such as hospitalizations and mortality. This automated approach aims to identify dangerous drug-drug interactions much faster than traditional methods to improve prescribing safety and inform regulatory decisions.

Matthew Weir

This economic evaluation used data from a large clinical trial linked with health databases in Alberta to compare the costs and health outcomes of starting dialysis early versus waiting for standard clinical triggers in critically ill patients with severe acute kidney injury. While waiting to start dialysis was slightly more expensive, it resulted in better quality of life and longer survival for patients over the long term. The findings suggest that a standard approach to starting dialysis is more cost-effective in the Canadian healthcare system than an accelerated approach.

Matthew WeirKyla NaylorAmit GargAndrea Cowan

This is a protocol for an ongoing pilot study that will assess the feasibility of conducting a larger trial to determine if the medication denosumab can prevent bone fractures in patients receiving hemodialysis. Researchers will recruit at least 60 high-risk patients across Ontario to evaluate how well the study procedures work and whether the treatment can be safely integrated into routine care. The findings will help determine if a full-scale study is possible to test a new strategy for reducing the high rate of fragility fractures in this population.

Matthew WeirPavel Roshanov

Researchers conducted a large international trial to determine if the medication spironolactone could reduce the risk of heart failure or cardiovascular death in patients receiving long-term dialysis. The study was stopped early for futility after finding no significant difference in heart-related deaths or hospitalizations between patients taking spironolactone and those taking a placebo. These results suggest that daily use of this specific medication does not provide the expected cardiovascular benefits for the maintenance dialysis population.

Matthew WeirBrad Urquhart

A study of older adults in Ontario found that taking the antibiotic clarithromycin while also using certain blood pressure medications, known as angiotensin receptor blockers, was associated with a higher risk of hospital visits for high potassium levels and acute kidney injury compared to taking azithromycin. This risk of high potassium was even greater for individuals with pre-existing reduced kidney function. These findings suggest a significant drug interaction occurs because clarithromycin interferes with the body's ability to transport and eliminate these blood pressure medications through the liver.

Louise MoistMatthew WeirKyla NaylorAmit GargPavel RoshanovPeter Blake

Researchers in Ontario, Canada, found that deaths among people with advanced chronic kidney disease increased by eight per cent during the first 21 months of the COVID-19 pandemic. Despite this increase in mortality, hospital admissions and emergency room visits for these patients actually decreased, suggesting a significant disruption in how they accessed medical care. Interestingly, visits to kidney specialists remained stable throughout the pandemic, and there was no significant change in the number of patients needing to start urgent dialysis.

Matthew WeirKyla NaylorAmit Garg

Researchers examined the steps required to receive a kidney transplant across different regional renal programs in Ontario, Canada, and found significant geographic disparities in access. Patients in Northern Ontario were much less likely to be referred for transplant evaluation, find potential living donors, or be placed on the deceased donor waitlist compared to those in Toronto. These findings highlight that even within a publicly funded health care system, a patient's location can greatly influence their ability to receive a kidney transplant.

Matthew Weir

A study of older adults in Ontario, Canada, found that starting a sodium-glucose cotransporter 2 inhibitor was associated with a lower risk of developing high potassium levels in those already taking medications that affect the renin-angiotensin-aldosterone system. Patients who began this new treatment were also less likely to stop their existing blood pressure and kidney-protective medications. These findings suggest that adding this class of drugs may help manage a common side effect of standard kidney and heart treatments in routine clinical practice.

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.

Matthew WeirKyla NaylorAmit GargPeter Blake

Researchers in Ontario, Canada, compared the health outcomes of over 31,000 dialysis patients before and during the first three years of the COVID-19 pandemic. While death rates were significantly higher during specific months of the pandemic, the overall mortality rate over the entire 36-month period was not substantially higher than expected. Interestingly, hospitalizations and emergency room visits decreased during the pandemic, yet there was no corresponding increase in deaths unrelated to COVID-19.

Matthew Weir

Researchers analyzed data from a large clinical trial to determine if waiting longer to start dialysis in critically ill patients with severe acute kidney injury affected their recovery. The study found that longer delays in starting dialysis were not associated with an increased risk of death, though there was a potential link between longer delays and a higher likelihood of remaining dependent on dialysis at 90 days. These findings suggest that for patients without urgent medical needs, a strategy of waiting to see if the kidneys recover naturally does not appear to worsen survival outcomes.

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.

Matthew Weir

This report describes the design of an ongoing global registry and an associated adaptive platform clinical trial aimed at identifying new treatments for people with chronic kidney disease. The registry tracks patient health and outcomes across multiple countries to identify eligible participants for the trial, which will test various medications and combinations to slow the decline of kidney function. The study uses an innovative trial structure that allows researchers to efficiently evaluate multiple therapies simultaneously using a shared placebo group.

Matthew Weir

Researchers conducted a pilot study in Canada and Australia to see if it is feasible to run a large trial comparing warfarin, apixaban, and no anticoagulation in patients on dialysis with atrial fibrillation. The study successfully met its goals for patient recruitment and treatment adherence, despite challenges posed by the pandemic. These results demonstrate that a larger, definitive trial can be conducted to determine the safest and most effective way to prevent strokes in this high-risk population.

Matthew WeirAmit Garg

In older adults with chronic kidney disease, starting oral antiviral medications for herpes at higher doses was associated with a nearly fourfold increased risk of acute kidney injury compared to lower doses. While the overall absolute risk of a serious kidney event remained low at less than one percent, the risk was significantly higher when measured using hospital laboratory data rather than diagnostic codes alone. These findings suggest that careful dose adjustment of these medications is important for patient safety in the context of reduced kidney function.

Matthew Weir

This study conducted an environmental scan of adult kidney transplant programs across Canada to understand how they manage patients whose kidney transplants are failing. Researchers found significant variations and gaps in care, particularly regarding psychological support, structured preparation for returning to dialysis, and multidisciplinary care. The findings highlight a lack of standardized protocols and a need for evidence-based guidelines to improve outcomes for this complex patient group.

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 WeirAmit GargBrad Urquhart

In older adults taking digoxin, starting a course of the antibiotic trimethoprim-sulfamethoxazole was associated with a nearly sixfold higher risk of hospitalization for digoxin toxicity compared to starting amoxicillin. While the absolute risk of this complication remained low at less than one percent, the interaction is clinically significant because digoxin has a narrow safety range. Physicians should consider using alternative antibiotics or reducing the digoxin dose when these medications must be used together.

Matthew Weir

Researchers in Ontario, Canada, found that people living with HIV who were on dialysis had a significantly lower chance of receiving a kidney transplant compared to those without HIV when accounting for the risk of death. Despite this disparity in access, the study found that long-term transplant success and survival rates were similar between patients with and without HIV. These findings highlight a potential inequity in access to transplantation for individuals living with HIV despite comparable clinical outcomes after the procedure.

Dervla ConnaughtonMatthew Weir

A woman who donated a kidney was later found to have a genetic mutation for Alport Syndrome that had initially been classified as a finding of uncertain significance. Five years after her donation, a re-evaluation of her genetic data and family history led to the discovery that the mutation was likely disease-causing, explaining her unexpected decline in kidney function. This case highlights the importance of periodically re-examining genetic test results, especially for potential living kidney donors, as scientific understanding of specific mutations evolves over time.

Matthew Weir

Researchers analyzed data from a large international trial to compare how doctors in different regions manage severe acute kidney injury in intensive care units. They found significant differences in fluid management and the timing and type of dialysis used, with patients in Australia and New Zealand showing higher survival rates at 90 days compared to those in North America and Europe. These findings highlight how regional variations in clinical practice may influence recovery and survival for critically ill 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.

Matthew WeirAmit Garg

This is a protocol for an ongoing study that describes a new approach to identifying drug safety signals in older adults with chronic kidney disease using high-throughput computing and automation. Researchers will use administrative health databases in Ontario to conduct over 700 automated cohort studies, comparing the risk of 74 different acute health outcomes between new users of various medications and non-users. By analyzing these risks across different levels of kidney function, the study aims to more efficiently detect adverse drug reactions in this vulnerable population.

Matthew WeirAmit GargBrad UrquhartPeter Blake

A study of older adults in Ontario, Canada, found that those with chronic kidney disease who started low-dose methotrexate had double the risk of serious adverse events, such as sepsis or lung and liver toxicity, compared to those starting hydroxychloroquine. This risk was even higher for individuals with more advanced kidney impairment, particularly those with an estimated glomerular filtration rate below 45. These findings suggest that the potential for severe complications should be carefully weighed against the benefits when prescribing methotrexate to patients with reduced kidney function.

Matthew Weir

Researchers analyzed data from a large clinical trial to compare whether starting treatment with continuous dialysis or intermittent dialysis led to better outcomes for critically ill patients with severe acute kidney injury. After adjusting for differences between the two groups, they found that patients who began with continuous therapy had a lower risk of being dead or still requiring dialysis 90 days later. This benefit was primarily due to a significant reduction in the number of patients who remained dependent on dialysis treatments.

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.

Matthew WeirDanielle NashAmit GargAndrea Cowan

A study of older adults in Ontario found that while the overall risk of developing low blood calcium after starting the medication denosumab is low, it increases significantly for those with advanced kidney disease or those on dialysis. For patients with the lowest kidney function, nearly one in four experienced mild low calcium and about fifteen percent experienced severe cases. These findings suggest that kidney function and baseline calcium levels are critical factors for doctors to monitor when prescribing this bone-strengthening treatment.

Matthew WeirAmit GargBrad Urquhart

This randomized trial investigated whether a highly absorbable form of curcumin could slow the progression of chronic kidney disease in adults with high levels of protein in their urine. Researchers found that taking 90 milligrams of micro-particle curcumin daily for six months did not significantly improve kidney function or reduce protein leakage compared to a placebo. These results suggest that this specific curcumin formulation does not provide measurable benefits for managing albuminuric chronic kidney disease over a short-term period.

Matthew WeirAmit Garg

A study of adults aged 66 and older in Ontario, Canada, found that starting the antibiotic trimethoprim-sulfamethoxazole was associated with a more than threefold increased risk of hospitalization for high potassium levels compared to starting amoxicillin. This risk was significantly higher for individuals with pre-existing reduced kidney function, and the medication was also linked to higher rates of acute kidney injury. These findings highlight the importance of monitoring kidney function and potassium levels when prescribing this common antibiotic to older patients.

Matthew Weir

This study examined whether having pre-existing chronic kidney disease affects the outcomes of different timing strategies for starting dialysis in patients with sudden, severe kidney failure. Researchers found that for patients who already had chronic kidney disease, starting dialysis early led to a three times higher risk of remaining dependent on dialysis after 90 days compared to a more standard, watchful approach. In contrast, the timing of dialysis initiation did not affect long-term dialysis dependence or survival for patients who had healthy kidney function before their acute illness.

Matthew Weir

Researchers re-examined data from a large international trial to determine if starting dialysis earlier in critically ill patients with acute kidney injury provided any benefit. Using advanced statistical modeling, they found a very low probability that early dialysis improves survival and noted that patients in the early-start group actually spent fewer days alive and free from dialysis. These results support the current practice of waiting for standard clinical indications before beginning kidney-replacement therapy.

Matthew WeirAmit Garg

This study of older adults in Ontario with advanced chronic kidney disease found that those prescribed higher doses of fluoroquinolone antibiotics had a higher risk of serious side effects compared to those given lower doses. These adverse events included hospital visits for nervous system or psychiatric disorders, dangerously low blood sugar, and tendon or collagen-related issues. While the overall risk of these complications remained low at less than two percent, the findings highlight the importance of careful dose adjustment based on kidney function.

Matthew WeirAmit GargPeter Blake

A study of older adults with chronic kidney disease in Ontario found that starting allopurinol at a dose higher than 100 milligrams per day more than doubled the risk of being hospitalized for a severe skin reaction compared to starting at a lower dose. These results support the practice of using lower initial doses of this medication in patients with reduced kidney function to minimize the risk of dangerous side effects. While higher starting doses were also linked to an increase in overall hospitalizations, there was no significant difference in the risk of death between the two groups.

Matthew WeirKyla NaylorAmit GargAndrea Cowan

Researchers compared the risk of bone fractures between older adults in Ontario starting sodium-glucose cotransporter-2 inhibitors and those starting dipeptidyl peptidase-4 inhibitors. The study found no significant difference in fracture risk between the two medication groups over one year, regardless of the patient's baseline kidney function. These findings suggest that this class of diabetes medication does not increase the risk of skeletal injuries in patients with chronic kidney disease.