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BP in HD Trial

Finding the Right Blood Pressure Target for Patients on Dialysis

High blood pressure in people receiving hemodialysis is known to contribute to cardiovascular morbidity and mortality through excess strokes, heart failure, left ventricular hypertrophy and arrythmias, whereas low blood pressure can lead to cramps, myocardial stunning, and cerebrovascular ischemia. However, despite, blood pressure management being a cornerstone of multidisciplinary rounds, the optimal blood pressure target for people on hemodialysis is unknown.

Finding the “right” blood pressure to target can have a major impact on patient lives. We are proposing a large, pragmatic, cluster randomized trial targeting a lower versus higher blood pressure target in in-centre hemodialysis units in Canada. Our initial steps towards this trial are to determine the current treatment practices in Canadian hemodialysis units – hypothesizing that the target blood pressure in Canadian hemodialysis units is highly variable and poorly implemented, in turn setting the stage for a lower versus higher blood pressure target protocol that can be provided in a future trial. Our ultimate goal is to deliver the definitive randomized trial for blood pressure targets in the hemodialysis population.

Dr. Navdeep Tangri

PI: Dr. Navdeep Tangri

Navdeep Tangri, MD PhD is a professor at the University of Manitoba, and the Scientific Director of the Seven Oaks Hospital Chronic Disease Innovation Centre. He also serves as an attending nephrologist at Seven Oaks General Hospital. Dr Tangri’s main research interest revolves around improving clinical decision-making for patients with advanced chronic kidney disease (CKD). His efforts in understanding CKD led to the development of the Kidney Failure Risk Equation (KFRE), used worldwide to predict the need for dialysis in patients with CKD. He is presently engaged in multiple validation and implementation exercises to increase the uptake of the KFRE.

In addition, Dr Tangri is conducting a large prospective study on physical and cognitive function in patients with advanced CKD, as well as comparative effectiveness studies and clinical trials on the safety and effectiveness of medical therapies in this population. He has published over 300 manuscripts and presented at multiple national and international scientific meetings.

Dr. Karthik Tennankore

Co-Investigator: Dr. Karthik Tennankore

Dr. Karthik Tennankore is an Associate Professor in the Department of Medicine, Division of Nephrology at Dalhousie University, Halifax, Nova Scotia. He is also QEII Foundation Endowed Chair in Transplantation Research.  He received his MD at the University of Western Ontario, and completed Internal Medicine and Nephrology at Dalhousie University. He went on to complete a two-year clinical fellowship in home dialysis at the Toronto General Hospital (University of Toronto), and concurrently obtained a Master of Science in Clinical Epidemiology through Harvard University.

Dr. Tennankore’s clinical interests mainly focus in the areas of home hemodialysis and peritoneal dialysis. His research interests are aimed at improving the health of patients with chronic kidney disease, including home dialysis patients and kidney transplant recipients, with a focus on frailty and its impacts on health outcomes. In addition, he is involved in both investigator-led and industry clinical trials, through the Canadian Nephrology Trials Network, and has conducted a number of prospective cohort studies in nephrology.

Dr. David Collister

Co-Investigator: Dr. David Collister

David Collister, MD PhD, completed his MD at the University of Manitoba, Internal Medicine Residency at the University of Alberta, Nephrology Fellowship at the University of Manitoba, and his PhD in Health Research Methodology at McMaster University. He is an assistant professor at the University of Alberta. His research focuses on symptom management in patients with kidney disease and, in particular, randomized controlled trials of therapies to alleviate symptoms in chronic kidney disease and dialysis.