Research
Many of Kidney CARE Network International’s members are directly involved, as students and/or volunteers, in several programs of research led by Dr. Charmaine Lok at Toronto General Hospital. Dr. Lok’s research programs focus on improving hemodialysis vascular access outcomes, improving neuromuscular function and mobility in CKD, and reducing cardiovascular events and mortality in CKD/ESRD.  A selection of these programs of research is presented here, with a summary directed at the general public, patient, and healthcare practitioner. Please feel free to contact us if you have any further questions.

Kidney CARE Members' Research Publications

Prevention of Heart Attacks and other Serious Cardiovascular Events in Hemodialysis Patients

Protection against Incidences of Serious Cardiovascular Events Study (PISCES)*
In North America, more than 450,000 people with kidney failure require dialysis. Cardiovascular (CV), (heart-and blood vessel) related events are the main causes of illness and death. However, there are no consistently proven medical therapies to reduce serious CV events. Fish oil may reduce risk factors that cause heart and blood circulation problems and improve health outcomes. Our overall goal is to study the effect of fish oil in reducing CV events in dialysis patients.

We aim to enroll about 1100 adult men and women who are on dialysis from different parts of the world. Eligible participants will be randomly assigned to receive fish oil capsules or placebo (dummy) capsules to ingest daily.  Participants will be followed closely for the duration of the study to see if they have any CV events. There are no known risks involved in participating in this study. New knowledge gained from the results of this study could impact the care given to dialysis patients immediately. If fish oil is found to reduce serious CV events it will significantly improve patient health and may reduce CV-event-related hospitalizations.

This study is centrally led by Dr. Charmaine Lok through the Toronto General Research Institute in Toronto, Canada.

Trial Status: Ongoing;
Recruitment status: Recruiting
Link:  http://www.isrctn.com/ISRCTN00691795
*This work is supported by a personnel award from the Heart and Stroke Foundation

Maintenance of Hemodialysis Lifelines- Vascular Access

Hemodialysis Infection Prevention with Polysporin Ointment in Satellite Centres
Hemodialysis (dialysis) patients are often advised not to shower if they have a central venous catheter (catheter), which often needed to provide life-sustaining dialysis. We developed a shower technique catheter protocol for dialysis patients with healed catheter exit sites, designed to permit showering but not increase catheter-related infection (infection) risk. We aimed to test the feasibility of conducting a rigorous study to compare the rate of infection in adult satellite dialysis patients using the shower technique protocol versus standard catheter care alone with 6 month follow up. Other important outcomes, such as patient quality of life are measured in Kidney CARE's members related studies.
Click here to see the publication.

Status: Study completed.

Perspectives of Hemodialysis Patients on Vascular Access

The Development of the Short Form- Vascular Access Questionnaire (SF-VAQ)
The primary objective of this study is to measure hemodialysis patients' satisfaction with their hemodialysis vascular access. This “access” is required for dialysis and is known as the hemodialysis patient’s lifeline. The secondary objective is to evaluate the measurement tool's psychometric properties to assess patient satisfaction with their vascular access.

We generated a comprehensive list of survey items related to patients' views and satisfaction with their vascular access and administered it to participating in-center hemodialysis patients over 4 months. Following a factor analysis, the items were reduced and rescaled to generate the final short-form vascular access questionnaire (SF-VAQ). The SF-VAQ was then validated on a new cohort of hemodialysis patients.

We have successfully developed the SF-VAQ - a short, simple to administer vascular access-specific questionnaire with robust psychometric properties that can be used to obtain the patient's views on their vascular access. Based on the newly developed SF-VAQ scores, patients were the most satisfied with a type of “native access” called fistulas.

Trial Status: Completed
  Research Link