Australian and New Zealand Society of Nephrology

Research Opportunity

Royal Brisbane and Women's Hospital - The Department of Renal Medicine

The Department of Renal Medicine is part of the Royal Brisbane and Women’s Hospital, which is the largest public teaching hospital in Australia. The hospital and co-located institutes have excellent teaching and research facilities and opportunities. The Renal Medicine Department provides renal services to the north side of Brisbane with an approximate population of 0.8-1.2 million. Services are delivered in a range of settings including innovative models of chronic care in community centres at Nundah and Northwest, hospital based services at the Royal Brisbane and Women’s and The Prince Charles Hospitals and independent services within both a community centre and at Caboolture Hospital. The services will expand with more chronic care and satellite haemodialysis at North Lakes.

Basic Science Research

The Royal Brisbane and Women’s Hospital has committed to developing research in the department with the appointment of a half time senior staff specialist in research. The Department has seven full time staff specialists, 2 advanced trainees, 3 general registrars and 3 resident medical officers. The research infrastructure is available for advanced renal trainees who are expected to undertake and complete a research project.

Dr Helen Healy leads a research program in the biology of renal tubular cell behaviour in progressive kidney disease. The work is conducted in a wet bench laboratory in the Bancroft Institute, Queensland Institute of Medical Research.

Associate Professor Glenda Gobe heads a research program in the mechanisms of kidney injury. The work is wet bench and located in the University of Queensland Centre for Clinical Research (UQCCR). The program includes collaborations between Dr Jonathan Peake in Associate Professor Glenda Gobe’s laboratory, Associate Professor Jeff Coombes and Professor Robert Fassett.

Associate Professor Jeff Coombes leads an oxidative stress and inflammation research group based at the School of Human Movement Studies at the University of Queensland. Associate Professor Coombes has recently acquired a mass spectrometer that extends the group’s capability to assessing oxidative stress by measuring plasma F2 isoprostanes.

Associate Professor Dominic Geraghty’s group at the School of Human Life Science, University of Tasmania are investigating immune cells in the sick environment in a study funded by the Clifford Craig Medical Research Trust.

Dr Cecilia Shing, University of Tasmania, is extending her collaborations with Renal Research to Brisbane renal researchers in several projects.

Basic Science Projects

A study is underway assessing the effects of antioxidants and exercise on vascular function and measures of oxidative stress and inflammation in the Apo E -/- knock out mice after 5/6 nephrectomy.

The Four immuno-study is assessing the effects of anti-rejection medication on vascular function in a rat model.

Antioxidant genotyping of superoxide dismutase, glutathione peroxidase and catalase is being studied in patients with CKD along with antioxidant enzyme activity over a twelve-month period.

Investigating the effects of exercise on the RhoA gene in endothelial cells in a renal cardiovascular model (ApoE knockout mouse with 5/6 nephrectomy)

Developing an assay to simultaneously measure markers of oxidative stress and antioxidant status in biological samples

A study is starting in 2009 assessing premature cell aging and its role in CKD and associated cardiovascular disease.

A study is underway assessing the influence of nutritional supplements on the secretion of inflammatory markers by peripheral blood mononuclear cells in patients with CKD.

Transient receptor potential vanilloid (TRPV) 1 and TRPV2 are being assessed in a study in hemodialysis patients.

Gene expression profiles of proximal epithelial cells in human chronic kidney disease

The role of human proximal epithelial cells as immune response cells

Clinical Science Research

Acute Kidney Injury

A study of vascular function in patients with acute kidney injury is underway assessing arterial stiffness in patients with acute kidney injury. This will be conducted in collaboration with Dr Vince D’Intini and Dr John Gowardman from the Intensive Care Unit at the RBWH.

Dr Vincent D’Intini will be developing collaborations with Professor Jeff Lipman studying pharmacokinetics and pharmacodynamics of drugs in ICU patients with acute kidney injury on hemofiltration.

Chronic Kidney Disease

The LORD (Lipid Lowering and Onset of Renal Disease) Trial has just been completed in Northern Tasmania with additional data analysis to be conducted over the next year.

Antioxidant Genotyping of superoxide dismutase, glutathione peroxidase and catalase is being studied in patients with CKD along with antioxidant enzyme activity over twelve months.

Palliative care is being studied in CKD patients in an NHMRC funded project, in which Professor Fassett is a Co-Chief investigator with Associate Professor Ros Bull in Northern Tasmania.

A study has been completed assessing the prevalence of renal artery stenosis in Northern Tasmania.

Peritoneal Dialysis

COMIVID this study is assessing measures of oxidative stress and inflammation along with vascular function in incident dialysis patients with the aim of comparing patients selecting peritoneal dialysis with those selecting hemodialysis.

The time of starting PD catheter use is being studied in a Trial led by Dr Dwaraka Ranganathan called the Timely PD study: A randomised controlled trial to determine the delay before dialysing through a PD catheter (1, 2 or 4 weeks) after its insertion
He is also studying the pharmacokinetics of intraperitoneal gentamicin in peritoneal dialysis patients with peritonitis in collaboration with Burns and Critical Care Research unit at the University of Queensland. A study of daily exit site mupiracin use in peritoneal dialysis is also underway.

Hemodialysis

COMIVID this study is assessing measures of oxidative stress and inflammation along with vascular function in incident dialysis patients with the aim of comparing patients selecting peritoneal dialysis with those selecting hemodialysis.

The ARTIST study is assessing arterial stiffness in incident hemodialysis patients in conjunction with Dr James Sharman at the School of Medicine at the University of Queensland at the Princess Alexandra Hospital.

The PEDAL study has recently been completed assessing exercise interventions in hemodialysis patients.

Mr Stuart Walker is leading the U-clip study and this is assessing U-clips compared with traditional suturing in arteriovenous fistula creation.

Differing vascular access catheter removal techniques are being assessed in a study being led by Dr Dwaraka Ranganathan.

Kidney Transplantation

The Xanthin study is randomised double blind placebo controlled trial assessing the effects of astaxanthin on measures of oxidative stress, inflammation and vascular function in kidney transplant patients.

Laparoscopic adjustable banding is being reviewed in obese kidney transplant patients and obese living donors for transplantation.

A report of congenital malformations associated with the administration of mycophenolate mofetil is being submitted for publication.

Proposed studies.

The effects of exercise training on depression on cardiovascular disease in patients with CKD.
Gamma tocopherol in ESKD a pilot study.
The effects of exercise and tocopherol supplementation on the progression of CKD and cardiovascular disease.
Is mixed tocopherol supplementation superior to alpha tocopherol supplementation in reducing atherosclerosis and cellular senescence in CKD and associated cardiovascular disease.
Epidemiology

The Centre for Chronic Disease at the University of Queensland studies chronic disease and its risk factors in high-risk populations.

Current initiatives include

1. A longitudinal (10-14 yr) study of the natural history of chronic disease in the Tiwi community in the NorthernTerritory.

2. Predictors of cardiovascular disease.

3. Studies of the influence of birthweight on chronic disease susceptibility

4. A genome scan of the Tiwi community and correlations with chronic disease profiles.

5. A randomised controlled trial of medical prevention of hypertension, albuminuria and renal disease in one remote Aboriginal community.

6. Programs to help improve chronic disease awareness in two remote Central Australian Aboriginal communities.

7. Participation in practice improvement projects in chronic disease in Queensland.

8. Collaboration with the Centre for Clinical Research Excellence in circulatory disease with a coalition of Aboriginal Medical Services in Queensland

9. Studies on patterns and trends of chronic disease deaths in Aboriginal people nationwide.

10. Proposed linkage studies to define patterns and trends of hospitalizations for chronic disease in Indigenous people in Queensland.

11. A study of the uptake and utilization of chronic disease medications in Queensland.

12. A review of Indigenous renal biopsies nationwide in Australia.

13. A multinational study of kidney ultrastructure in coronial (forensic) autopsies.

Australasian Kidney Trial Network (AKTN)

Professor Fassett is a member of the Trial Management Committee for the HERO study. The Renal department at the RBWH will be participating in this study.

Pharmaceutical Company Trials

The Department of Renal Medicine is participating in the following National and International Clinical Trials And Observational Studies

The SHARP study
The ASCERTAIN study
The IDEAL Trial
Dialysis Outcomes and Practice Patterns Study (DOPPS)
The AURORA study
The BALANZ study
Sirolimus 407 study
The ALTERNATE study
The EVOLVE study
The DORADO study
The EXTEND study
The IMPENDIA study
General Studies

The effects of a orally active form of superoxide dismutase (GLiSODin) on fatigue.
The effects of b-alanine on muscle function in Queensland Rugby players.

Contacts

Dr  Jeff  Coombes
P :
F :
E : jcoombes@uq.edu.au

Professor  Robert  Fassett
P : +61419399571
F :
E : rfassett@mac.com

Dr  Helen  Healy
P :
F :
E : Helen_Healy@health.qld.gov.au

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