Clinical and/or Basic Research

The Division of Nephrology and Transplantation Immunology at the University of Alberta will provide a rich research environment for trainees entering the program. No matter the eventual path of Nephrologists trained here, each resident will have some exposure to research, as required by the Royal College of Physicians and Surgeons of Canada. Trainees will choose among research projects in clinical epidemiology, ethics, health economics, transplantation immunology and vascular biology. In general, the trainee will choose a research program of interest during the first year of training through direct discussion with the potential mentors. Residents who choose to pursue a purely clinical career are encouraged to choose work in a clinical project. For trainees who wish to embark on an academic career in Nephrology, a two-year fellowship is generally required. For this career path, formal basic research or clinical epidemiology fellowship training is available in this Division. Research electives during the two-year Nephrology residency serve as an excellent mechanism to launch the fellowship project. All trainees should plan on writing up their project at the end of the second year of Clinical Nephrology Residency for presentation at local and/or national meetings and for potential inclusion in a research paper.

Strong Research Programs:

1. Transplantation Immunology: Principal Investigator: Philip Halloran, M.D.
   Dr. Halloran's laboratory focuses on cellular signaling mechanisms involved in transplant rejection, the development of transplant tolerance, and renal cell senescence. Dr. Halloran is a leading expert in these areas of investigation. His work spans bench to bedside. The trainee entering this laboratory can expect to learn state-of-the art genomic and proteomic approaches that will aid in defining the mechanism of transplant rejection
2. Glomerular Endothelial Cell Biology: Principal Investigator: Barbara J. Ballermann, M.D.
   This laboratory is defining the cellular and molecular mechanisms of glomerular endothelial cell development and differentiation, work that relates directly to the pathophysiology of pre-eclampsia and the hemolytic uremic syndrome. Dr. Ballermann is a recognized leader in this area of research. She also has extensive experience in fostering the career development of academic physicians. The trainee entering this laboratory can expect to undertake basic research that involves state-of-the art molecular and cell biology, as well as genomic/informatics approaches to cell differentiation
3. Cell Biology of the Endothelial Response to Inflammation: Principal Investigator: Allan Murray, M.D
   This laboratory explores the interaction of endothelial cells with leukocytes during inflammation. Endothelial cell activation is essential for the movement of leukocytes into areas of inflammation, whether the inflammatory response is due to rejection, microbial infection or autoimmune mechanisms. The trainee entering this laboratory will explore mechanisms that allow lymphocytes and other leukocytes to attach and then transmigrate the endothelium, using highly advanced real-time imaging systems as well as molecular approaches
4. Efficacy and Ethics in End Stage Renal Disease: Principal Investigator: Sara Davison, M.D.
   This research program is concerned with quality of life questions that impact patients with end stage renal disease and the physicians that care for them. Dr. Davison holds an appointment in the Dossetor Health Ethics Center of the University of Alberta. The trainee entering this area of research will be trained in ethical aspects of the Nephrologist's approach to patient care.
5. Health Economics in Nephrology: Principal Investigator: Scott Klarenbach, M.D.
   The principal investigator of this program focuses on questions that relate of the economics of health care delivery in patients with end stage renal disease. The trainee in this area of research will be exposed to both, clinical epidemiological and health economics principles.
6. Renal Transplantation Outcomes: Principal Investigator: Sita Gourishankar, M.D.
   This program explores the clinical and pathological characteristics of patients with renal transplants. The one-year survival of transplants is now greater than 95%, but patients still suffer from chronic progressive loss of renal transplant function, most often not responsive to immunosuppressive therapy. The work of Dr. Gourishankar seeks to shed light on the causes and potential treatment of this chronic renal transplant failure. The trainee embarking on a research project in this area will be exposed to methods in clinical outcomes research and to renal pathology as it relates to transplant rejection and chronic transplant failure.
7. Clinical Research in Dialysis: Principal Investigator: Kailash Jindal, M.D.
   This research program provides opportunity for conducting research in dialysis technology. The principal investigator has had experience in conducting clinical research in the areas of dialysis adequacy, clinical performance of dialysis membranes and the impact of reuse methodologies on dialysis membranes and vascular access monitoring. The trainee entering this research program will have an opportunity to be trained in the impact of dialysis technology in the new dialysis modalities.
8. Systemic consequences of renal dysfunction; Principal Investigator: Branko Braam, M.D., Ph.D.
   Dr. Braam's line of research stretches from Care Redesign Research to Applied Molecular Biology. His translational research focus is on hypertension and cardio-renal interactions. Projects involve cell-based experiments on the one hand, and patient-related research on the other. Technologies in the lab involve cell culture, quantitative PCR, Western blotting, FACS, gene expression analysis using microarrays, confocal imaging, ELISA's. Technologies in the clinic involve pulse wave analysis, renal function measurement, questionnaires, on-line educational tools, and in collaboration with other database-base mining. Dr. Braam is a recognized expert in renal hemodynamics, hypertension and heart kidney interactions. He has trained many young researchers at various levels of training.
9. Home Hemodialysis: Principal Investigator: Robert Pauly, M.D.
   The primary goal of this research program is to investigate the role of intensive hemodialysis therapies (nocturnal hemodialysis and short daily hemodialysis) in the spectrum of end-stage renal disease. Projects revolve around patient survival with these therapies compared to other treatment strategies, predictors of modality success, and increasing the uptake and acceptability of these treatments for patients and the health care system. The trainee entering this research program can expect to learn some fundamental principles of epidemiological research.
10. Clinical Research in Acute Kidney Injury / Quality Improvement in CKD/ESRD: Principal Investigator: Neesh Pannu M.D.
    This research program provides an opportunity for conducting research in the area of AKI epidemiology using large population based datasets. In addition there is the opportunity to identify gaps in the care of patients with CKD/ESRD treated in the Northern Alberta Renal Program and to develop and evaluate quality improvement initiatives.

Objectives:

Expectations of resident during research rotation

The resident will:

• Contact mentor in a timely fashion in advance of project to ensure project feasibility
• Work with the research supervisor and support staff including colleagues, statisticians, and research associates and study participants to facilitate completion of the research project
• Report progress on a weekly basis directly to his/her research supervisor
• Learn the basic principles of scientific writing
• Disseminate results of project through submission of a poster or a manuscript and a local presentation (Kidney Matters meeting)
• Effectively manage time and resources during research block and ensure that project is completed in a timely and cost effective fashion
• Learn to organize and manage research data
• Choose projects reflective of the needs of the renal population that they serve. This may include quality improvement initiatives
• Respect patient privacy through effective data management
• Critically appraise relevant evidence to address a research question and integrate this information into the design, analysis and interpretation of a research project
• Learn principles of Quality Improvement - where applicable
• Complete projects in a timely fashion
• Obtain training in and demonstrate the ethical approach to human research subjects, including maintaining confidentiality, the responsible treatment of research ideas and data, and in the ethical treatment of research animals