Major research themes in clinical science at HCKR include:

Diagnosis and Management of Newly Diagnosed Kidney Disease

We are currently conducting a number of studies that will optimize the care of patients with newly diagnosed kidney disease. These studies include:

• Evaluating the optimal timing for referral of a patient with newly diagnosed chronic kidney disease (CKD) to a nephrologist (SIM-CKD)
• Optimizing fluid management in patients with acute kidney injury in the ICU (BIOVISION)
• Evaluating treatment strategies in patients with renal vasculitis (PEXIVAS; FIG)

Progressive Chronic Kidney Disease

Some patients with earlier stages of kidney disease will progress to more advanced chronic kidney disease and may ultimately need to start dialysis or receive a kidney transplant. Studies on these patients include:

• The influence of fluid retention on outcomes in patients with CKD (CANPREDICT BIA)
• Improving the use of home-based dialysis therapies (WISHED)

Patient-oriented Dialysis Research

About 25,000 patients in Canada require dialysis due to the failure of their kidney function. These patients often have poor quality of life and a shortened life expectancy. Studies are currently being conducted to improve their quality of life and reduce the risk of serious adverse clinical events. These studies include:

• The use of a cardio-protective medication in hemodialysis patients (PHASE)
• The impact of calcium-based phosphate binders on cardiovascular outcomes in HD patients (TARGET)
• The impact of the hemodialysis treatment on patient’s symptoms (SYMPTOMS, HOST TIME, MORE Time, FLUID)
• The optimal exercise regimen in hemodialysis patients to improve physical function and well-being (THESIS)
• The optimal management of anticoagulation during hemodialysis (HEMOTIN)

Patient-oriented Transplant Research

Kidney transplantation improves the quality of life and life expectancy of patients who are dialysis-dependent. Nevertheless, patients with kidney transplantation are at increased risk of early cardiovascular disease and loss of the transplant kidney over time. A number of studies are underway evaluating predictors of cardiovascular disease in these patients and early predictors of graft loss:

• Predictors of cardiovascular events in renal transplant patients (SCORE)
• Identifying markers of early renal scarring in transplant recipients (FIG)
• The risk of venous thromboembolism in patients with a newly received kidney transplant (REPORT)