Study: KidneyCARE (Community Access to Research Equity) Study
Protocol (REB: 25-23): The KidneyCARE Study is an international, web-based chronic kidney disease (CKD) patient registry designed to link patient-entered data—including health history, preferences, and patient-reported outcomes (PROs)—with clinical and laboratory data from electronic medical records (EMRs) in Dr. Prasad’s Clinic and other sources. Primary objectives include creating an interactive CKD patient community, providing educational resources, and building a robust database to support research, clinical care, and policy. Secondary objectives involve facilitating clinical trial recruitment and patient-centered trial input, while exploratory objectives aim to analyze healthcare utilization and cost data to inform CKD research and care strategies.
Study: Gender-Based Barriers to Referral for Kidney Transplantation in Canada: The Patient’s Perspective (CAN TRANSPLANT)
Protocol (REB: 22-58): Sequential mixed-methods study to explore gender-based differences in attitudes toward kidney transplantation (KT) among patients with end-stage kidney disease (ESKD) in a contemporary Canadian cohort. Phase 1 involves focused group discussions (FGDs) to identify common emotional reactions and concerns regarding KT. Phase 2 develops a transplant questionnaire based on FGD themes to quantitatively assess differences in attitudes between men and women. Phase 3 examines whether gender-specific attitudes are associated with key transplant outcomes, including referral rates, completion of pre-transplant workup within one year, and initiation of living donor workup within one year.
Study: Pragmatic randomized trial of High Or Standard PHosphAte Targets in End-stage kidney disease (PHOSPHATE)
Protocol (REB: 24-65): Randomized controlled trial to evaluate whether intensive phosphate-lowering therapy, targeting serum phosphate ≤1.50 mmol/L, reduces the risk of fatal and non-fatal major adverse cardiovascular events compared to a liberalized phosphate control strategy in patients with end-stage kidney disease (ESKD) receiving dialysis. The study will assess patient-centered outcomes, including cardiovascular morbidity, mortality, physical health, fatigue, and well-being. The trial is grounded in robust basic science and observational data linking hyperphosphatemia with vascular calcification, endothelial dysfunction, left ventricular hypertrophy, and cardiovascular mortality, addressing the current lack of RCT-level evidence for phosphate-lowering strategies in dialysis patients.
Study: LoW Dose-Intensity vs. Standard Dose-Intensity COntinuous Renal ReplaceMent Therapy in Critically Ill Patients (WISDOM): A Pilot Randomized Trial
Protocol: (REB 24-110)The WISDOM pilot trial aims to determine whether a lower CRRT dose-intensity (10–15 mL/kg/hr) in critically ill patients with acute kidney injury is non-inferior to the current guideline-recommended standard (25–30 mL/kg/hr) for 90-day mortality, and whether it may reduce RRT duration and improve kidney recovery. Although KDIGO guidelines recommend 20–25 mL/kg/hr, delivered doses are often lower due to therapy interruptions, and no RCT has established a minimally effective dose. This study will evaluate the feasibility of administering lower versus standard CRRT dose-intensity, providing foundational data for future trials to optimize CRRT delivery and patient outcomes.
Study: Central Blood Pressure Targeting: A pragmatic Randomized Trial in advanced Chronic Kidney Disease (Pilot study) CENTRAL CKD
Protocol: (REB 22-33)This pilot study will assess whether targeting central systolic blood pressure (SBP) <130 mmHg, compared to standard brachial SBP <130 mmHg, is feasible in patients with advanced chronic kidney disease (CKD) and whether it reduces arterial stiffness, a surrogate for cardiovascular risk. Hypertension is highly prevalent in CKD, yet optimal BP management remains uncertain, as brachial BP may poorly reflect central aortic pressure, particularly in advanced CKD. Central BP measurement, achievable with validated devices, correlates more closely with cardiovascular outcomes. This study will provide preliminary data on the feasibility, safety, and potential benefits of central BP-guided therapy, informing the design of larger trials to evaluate effects on major cardiovascular events, progression to end-stage kidney disease, and patient-reported outcomes.
Study: Frailty and the Kidney Transplant Waitlist
Protocol: (REB 19-112) This multi-center prospective cohort study will enroll adult patients referred for kidney transplant waitlist eligibility across Canada, including 60 patients from Regina, with follow-up of 1–4 years. The primary outcome is time to death or permanent waitlist withdrawal, and secondary outcomes include changes in frailty, hospitalizations, quality of life, agreement between frailty measures, and probability of being listed. Approximately 1,200 patients will be enrolled nationally, providing adequate power to detect clinically meaningful differences between frail and non-frail patients. Analyses will use Fine and Gray sub-distribution hazards models for the primary outcome, generalized estimating equations and mixed-effects models for longitudinal frailty and quality-of-life changes, Anderson-Gill models for recurrent hospitalizations, Bland-Altman and Cohen’s kappa for measuring agreement, and logistic regression for adjusted odds of waitlist activation.
