BP in HD Trial
Finding the Right Blood Pressure for Patients on Hemodialysis
High blood pressure in people receiving hemodialysis contributes 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. This trial team is proposing a large, pragmatic, cluster randomized trial targeting a lower versus higher blood pressure target in in-centre hemodialysis units in Canada. Their 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. Their ultimate goal is to deliver the definitive randomized trial for blood pressure targets in the hemodialysis population.
Presentation Slides
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 to understand CKD led to developing the Kidney Failure Risk Equation (KFRE), used to predict the need for dialysis in CKD patients. He is presently engaged in multiple validation and implementation exercises to increase the uptake of the KFRE.
Dr Tangri is conducting a large prospective study on physical and cognitive function in patients with advanced CKD. Additionally, he’s conducting 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.
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 also acts as QEII Foundation Endowed Chair in Transplantation Research. Having received his MD at the University of Western Ontario, he then completed Internal Medicine and Nephrology at Dalhousie University. Then, he completed a two-year clinical fellowship in home dialysis at the Toronto General Hospital (University of Toronto). He 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.
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.