HRC success in Christchurch

The Health Research Council announced Programme and Project grant recipients.  Here’s the list from the Christchurch campus of the University of Otago in which I get a brief mention :).  If others have abstracts of successful grants they’d like posted on this blog, then please let me know.

*****Update: It’s come to my attention that this announcement sent to Uni Otago staff left off the investigator lists investigators who were not current University staff.  I’ve added a few I know about below, but here may be others left out of the list, sorry.  ****

Monday, 9 June 2014.

University of Otago, Christchurch researchers have been awarded more than $8 million of Health Research Council 2014 funding. The results were announced by Minister Steven Joyce at 11.30am today.

The funded projects are:

  • HRC Programme Grant to Professor Mark Richards: Heart Failure: markers and management ($4,980,858).
  • HRC Project Grant to Professor David Murdoch: Legionnaires’ disease in New Zealand: improving diagnostics and treatment ($999,467).
  • HRC Project Grant to Dr Ben Hudson: A randomised controlled trial of nortriptyline in knee osteoarthritis ($1,190,921).
  • HRC Project Grant to Professor Tim Anderson Genetics, brain imaging, and cognitive decline in Parkinson’s disease ($1,178,804).
  • Emerging Researcher First Grant to Dr Tracy Melzer: Imaging markers of imminent cognitive decline in Parkinson’s disease ($149,943).

A summary of each project follows:

HRC Programme Grant to Professor Mark Richards ($4,980,858)

Heart Failure: markers and management

Heart failure (HF) will affect 20% of people now aged 40 years and confers high rates of early readmission and death.  Professor Richards and his team will implement an integrated programme addressing unmet needs in HF including: (1) The IMPERATIVE-HF controlled trial of intensified immediate post-discharge management using special blood tests to individually grade risk and guide intervention with rapid adjustments to treatment to improve outcomes. (2) Testing of candidate kidney damage markers for early warning of this frequent and dangerous complication of HF. (3) Establishing correct sampling times for novel markers for best prediction of early and long term outcomes in HF. (4) Testing our newly discovered markers for early warning of pneumonia complicating HF. (5) Clarification of diagnoses and testing management plans for patients in the Emergency Department with breathlessness or chest pain who do not have clear-cut HF or heart attacks but who nevertheless have elevated blood biomarkers and a poor outlook.

Other investigators are: Prof Vicky Cameron, Prof Richard Troughton, A/Prof Chris Pemberton, A/Prof Miriam Rademaker, A/Prof Chris Frampton, Prof Chris Charles, Dr Leigh Ellmers, Medicine, A/Prof John Pickering, Dr Anna Pilbrow (all University of Otago). Professor Zoltan Endre (University of New South Wales), Dr Martin Than (ED, Christchurch District Health Board), Prof Robert Doughty (University of Auckland), Dr James Pemberton (Cardiology, Auckland District Health Board)

HRC Project Grant to Professor David Murdoch ($999,467)

Legionnaires’ disease in New Zealand: improving diagnostics and treatment

Legionnaires’ disease is a severe type of pneumonia that is under-diagnosed in New Zealand. Special tests are required to make a diagnosis of legionnaires’ disease, but there are no clear guidelines about which patients to test. An enhanced testing system for legionnaires’ disease was developed in Canterbury and has been used there since 2010. The system involves targeted use of the current best test for legionnaires’ disease: PCR(polymerase chain reaction), which detects bacterial DNA. This approach has uncovered many cases of legionnaires’ disease that would have otherwise gone undetected. This study will roll out this same testing strategy across New Zealand for one year in order to measure the national burden of legionnaires’ disease, toimprove patient treatment, to identify cost-effective ways to test for legionnaires’ disease in the future, and to create better guidelines for the treatment of pneumonia.

Other investigators: A/Prof Patricia Priest, Prof Stephen Chambers, Dr Ian Sheerin.

HRC Project Grant to Dr Ben Hudson ($1,190,921)

A randomised controlled trial of nortriptyline in knee osteoarthritis

Osteoarthritis (OA) is a very common and painful condition.  Medicines currently available for treating OA pain are not ideal: they are either inadequately effective or cause unpleasant or dangerous side effects. Recent research has shown how the brain processes pain in OA and this has opened up the possibility of using different types of medicines for OA pain.  Nortriptyline (an antidepressant) has been used to treat persistent pain in other conditions, and other antidepressants may reduce pain in knee OA.  It is not known whether nortriptyline is useful in this condition.  We plan to test this effect by randomly allocating participants to treatment with nortriptyline or placebo and to measure changes in their pain before and after a period on the medication.  We hope that this will tell us whether nortriptyline will be helpful.  If it is, then we believe that many people may benefit from taking this medicine.

Other investigators: Prof Les Toop, Prof Lisa Stamp, Dr Jonathan Williman, Prof Gary Hooper, A/Prof Dee Mangin, Ms Bronwyn Thompson

HRC Project Grant to Professor Tim Anderson ($1,178,804)

Genetics, brain imaging, and cognitive decline in Parkinson’s disease

Many people with Parkinson’s are at risk of dementia but scientists and clinicians have been unable to predict when that will occur. Professor Tim Anderson and his team will do advanced brain scans (MRI and PET) gene testing and clinical evaluations in 85 Parkinson’s patients who have mild cognitive impairments, who are known to be at higher risk, and then determine whether they progress to dementia over the subsequent three years. By identifying characteristics present in the scans and genetic tests of those who develop dementia, compared to those who do not, Professor Anderson and his team can advance understanding of this important issue and establish a useful and reliable tool for researchers and clinicians. It is critical to do this so that preventative treatments to protect against dementia can be targeted at the most appropriate patients when that treatment becomes available and also to select the right ‘at risk’ Parkinson’s patients for trials of new treatments.

Other investigators are: Prof Martin Kennedy, Dr Tracy Melzer, Dr John Pearson.  Prof. John Dalrymple-Alford (University of Canterbury), Dr Ross Keenan (CDHB, Christchurch Radiology Group), Prof. David Miller (University College London)

HRC Emerging Researcher First Grant to Dr Tracy Melzer ($149,943)

Imaging markers of imminent cognitive decline in Parkinson’s disease.

Most Parkinson’s disease (PD) patients eventually develop dementia, which is the most burdensome aspect of this progressively worsening condition.  Mild cognitive impairments often indicate imminent dementia, but the two to 20 year time course poses a major problem for medical interventions, as brain changes associated with dementia in PD are still poorly understood.  Recent evidence suggests that neurodegenerative diseases such as PD progress along discrete brain networks.  One important network, known as the ‘default mode network’ appears particularly susceptible to neurodegeneration. Dr Melzer and his team will examine this network to determine if its disruption can specify which PD patients are vulnerable to progression to dementia within the next two years. A sophisticated but readily available brain imaging technique, called resting state functional imaging, will be used. These measures will assist in the selection of the most suitable patients for new treatments that may delay or prevent subsequent dementia in this vulnerable population.

The other investigator is: Prof Tim Anderson. Prof. John Dalrymple-Alford (University of Canterbury), Dr Ross Keenan (CDHB, Christchurch Radiology Group), Dr Daniel Myell (NZ Brain Research Institute)

 

A taste of success

Some recent successes of University of Otago Christchurch researchers:

Chlorine bleach key in disease?

Professor Tony Kettle from the Centre for Free Radical Research has won a prestigious Marsden Fund grant to better understand a ‘Jekyll and Hyde’ chemical with a role in heart disease, cancer, cystic fibrosis, and rheumatoid arthritis.

Professor Kettle will investigate chlorine bleach’s role in strengthening collagen by linking to form a resilient mesh. Without this mesh people can develop cataracts and an autoimmune disease that destroys the kidneys and causes the lungs to hemorrhage. However bleach can also have negative effects.

“Chlorine bleach should be viewed as a natural chemical with a Jekyll and Hyde personality. It helps us to fight infections and form strong connective tissue but also endangers our health during uncontrolled inflammation.”

Professor Kettle and his team will work with researchers from Vienna and Budapest on the project.

Improving the treatment and experience for dialysis patients

Chronic kidney disease is common, affecting about 500,000 New Zealanders. It is important because it increases chances of heart disease and death and may lead to needing treatment with dialysis or a kidney transplant. Dialysis therapy is a heavy and costly burden for patients and their families and the health system. However, there is a lack of reliable evidence to improve patient outcomes.

Dr Suetonia Palmer has just been awarded a prestigious Rutherford Discovery Fellowship valued at $800,000 over five years for research project called: “Improving evidence for decision-makers in chronic kidney disease.”

Dr Palmer’s research aims to to provide rigorous overviews of existing research and participant-led enquiry to provide better and more useable information for clinicians, consumers and policy-makers in the field of chronic kidney disease.

Recovering from food addiction

Professor Doug Sellman and his team from the National Addiction Centre have just been granted funding to trial a new treatment for those with obesity called Kia Akina.

“There is a serious need to develop new non-surgical ways of treating obesity because obesity-related diseases are expensive for New Zealand, traditional non-surgical methods are not working, and surgery is very costly,” says Professor Sellman.

Kia Akina uses a ‘food addiction’ approach to obesity. Professor Sellman says the project will test the feasibility, short-term effectiveness and participant satisfaction ofKia Akina within a primary health care setting.

If shown to be effective, Kia Akina will be developed as a non-commercial, low cost network for obesity recovery throughout New Zealand.

Innovation in Indigenous Health

Christchurch’s Maori/Indigenous Health Institute (MIHI) recently won the Australasian award for ‘innovation in Indigenous health curriculum implementation’ at the Leaders in Indigenous Medical Education (LIME) conference.

The LIME conference brings together all 20 medical schools throughout Australia and New Zealand, and hosts attendees from the United States and Canada.

Staff and students of the University of Otago, Christchurch, in Darwin at the Leaders in Indigenous Medical Education (LIME) conference

Staff and students of the University of Otago, Christchurch, in Darwin at the Leaders in Indigenous Medical Education (LIME) conference

MIHI director Suzanne Pitama says she and her team were thrilled to receive the award. As there is much collaboration between indigenous teaching teams at University of Otago’s Christchurch, Wellington and Dunedin campuses, the award recognises the innovation of all these teams.  It also recognised the systemic support within the University of Otago to prioritise indigenous health within the curriculum.

MIHI oversees the Maori health component of the medical curriculum at the University of Otago, Christchurch.

Award nominees are judged on how well their teaching programmes demonstrate their commitment and experience to understanding and furthering the health of Maori and Indigenous peoples.

The award has been presented for four years, says Pitama. MIHI also won it in the inaugural year.

A review panel of academic peers and members of indigenous medical doctors associations judge the award, Pitama says.

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This guest post was written by Kim Thomas,  Senior Communications Advisor, University of Otago, Christchurch, www.uoc.otago.ac.nz.

Legionnaires’ disease more common than once thought

Infectious diseases expert Professor David Murdoch is passionate about his work in better understanding legionnaires’ disease and its causes.

“If I ever have the opportunity in my career to help eradicate a disease it would likely be legionnaires’ disease. It’s the most common cause of pneumonia for much of the year in Christchurch and it has a far greater impact on community health and the hospital than people realise.’’

Professor David Murdoch, University of Otago Christchurch

Professor David Murdoch, University of Otago Christchurch

Professor Murdoch has just published research showing the potentially fatal disease is four times more prevalent in Canterbury than previously thought. He believes the results will apply to other centres and has sought funding to do New Zealand-wide research.

Professor Murdoch says special tests are required to diagnose legionnaires’ disease because it looks the same as other forms of pneumonia on an x-ray and has similar symptoms.

It is important to know if a patient has legionnaires’ disease as specific antibiotics are required to treat it which differ from the standard treatment for pneumonia.

Professor Murdoch says he and colleagues from the Canterbury Health Laboratories introduced a new strategy in 2010 whereby all samples from Canterbury patients with pneumonia were tested for legionnaires’ disease.

“It’s a very simple approach but we don’t think anyone else has done this globally.’’

“We have more than quadrupled the detection of legionnaires’ disease with this new strategy and highlighted a big spring/summer peak in activity that is more predictable every year in Christchurch than influenza. This peak is associated with gardening activities but the actual cause is not known.’’

Professor Murdoch is now studying Cantabrians who test positive for Legionnaires’ disease in greater depth to try and understand what specific gardening activities or other activities are implicated.

___________________________

This guest post was written by Kim Thomas,  Senior Communications Advisor, University of Otago, Christchurch, www.uoc.otago.ac.nz.

Television New Zealand news article relating to this issue: http://tvnz.co.nz/national-news/researchers-hope-uncover-cause-deadly-disease-5702569

 

 

Papanui Campus closes!

917 days; 131 weeks; 2.5 years.  However you look at it, it’s a long time to be temporary.  Today the Papanui Campus of the University of Otago Christchurch, a.k.a the Versatile workshop in my front yard, closed.  The sole permanent occupant (moi) became the last of the academics to return to the “main building” of the University of Otago Christchurch after we were unceremoniously evicted on 22 February 2011 (about time someone came up with a better name than “Main Building”). I’ve written elsewhere of that day when I commemorated two years since the earthquake and of the value of the Papanui campus when it turned  800 days. I’ll miss having the family close (perhaps not the dog), impromptu games of basketball (only 5 minutes boss…honest), and being on hand during that time when we went through all that shaking.  I shan’t miss the cramped space, the expense, or the loss of a workshop (maybe my son will be able to have his train set up again!). Today marks a new era for me as I return to an office in the centre of the Christchurch campus … I hope to discover some colleagues here that exist in the flesh and not only as words or images in cyberspace. In the process I hope to continue those incremental discoveries which will lead to better health for many.  My department has just endorsed a new plan for that… but that is the topic of a future post.

Two new Health Research Council grants worth crowing about

This week’s announcement by the HRC of Feasibility Study and Emerging Researcher grants have many great projects.  Two in particular are worth crowing about (because they have some relationship to kidneys and they involve two excellent people).  I have put summaries in their own words below, but first my comments.

Dr Palmer (Department of Medicine, University of Otago Christchurch), who has appeared on this blog site before, conducts what in the trade are called “meta-analyses” and “systematic reviews.”  Simply put, these are methods to extract the best possible evidence from all the studies that have been done for the effectiveness of a treatment.  Just as one person may toss a coin 4 times in a row and get 4 heads, so too can any one trial give a mistaken impression that a treatment is efficacious (or not) when it really isn’t (or is).  By pooling together many treatments Suetonia provides the very best quality evidence available.  Given that Chronic Kidney Disease affects a large and growing proportion of us, knowing which treatments have the best outcomes is of national significance, not merely to our health but also to the national budget.  A particular problem is that after a trial it can be many many years until meaningful health outcomes are know (e.g. if the treatment delays dialysis need or reduces mortality).  Suetonia’s study will assess the effectiveness of surrogate endpoints for clinical trials.  Surrogate endpoints, such as plasma creatinine which I’ve discussed many time in this blog, are physiologically related to the functioning of an organ or to a disease state as well as statistically associated with future hard outcomes.  However, their use in trials is limited by how well they are associated and how they are used.  I look forward to finding out what Suetonia discovers.

Mrs Rachael Parke (Auckland DHB) is an experienced nurse undertaking a PhD. Ensuring patients have adequate fluids on board is particularly crucial to the kidneys and other organs. Obviously with surgery any blood loss needs to be compensated for. However, there are also physiological changes in where fluid is distributed throughout the body.  Cardiopulmonary bypass, used in cardiac surgery, is a particular risk factor for Acute Kidney Injury. In the past the practice has been to give large amounts of fluid in order to ensure adequate fluid is given.  However, recent research has shown that too much fluid can have a negative impact (increased mortality).  A more restrictive fluid regime may have very meaningful outcomes.  Rachael is investigating, in a randomised controlled trial, if restricting fluid improves outcomes.  The outcome she is most interested in is how long patients stay in the hospital.  This is a very practical outcome for both patient and budget.  I am particularly pleased that this study is nurse-led.  Nurses play an incredibly important role in research as well as patient management.

In their own words:

Dr Suetonia Palmer: Making better clinical decisions to prevent kidney disease

More than ten percent of adults will develop chronic kidney disease. The effectiveness of many treatments used to improve outcomes in kidney disease is tested against surrogate (indirect) markers of health (e.g., cholesterol levels or blood pressure).

Unexpectedly, subsequent systematic analysis has identified little evidence to show that treatment strategies based on these surrogate markers translate to improved health for patients. Serum creatinine and proteinuria levels are commonly-used markers of kidney function to guide treatment.

The research involves using systematic review methods to summarise the quality of evidence for using proteinuria and serum creatinine as markers of treatment effectiveness in clinical trials. It will be determined whether using these markers to guide clinical care improves patient health or, conversely, leads to treatment-related harm or excessive use of ineffective medication.

These summaries will help clinicians and patients make better shared decisions about which therapeutic strategies actually improve clinical outcomes in kidney disease.

Mrs Rachel Parke: Fluid therapy after cardiac surgery – A feasibility study

Following cardiac surgery, patients receive large amounts of fluid in the intensive care unit. This may cause problems with wound healing and delay hospital discharge. A planned randomised controlled trial of a restrictive fluid regime as compared to a more liberal approach utilising advance hemodynamic monitoring, aims to reduce the amount of fluid patients receive and reduce hospital length of stay. This feasibility study aims to determine whether this nurse-led protocol is practicable and feasible and will help answer the research question. This study is simple and inexpensive and if it demonstrates a decreased length of hospital stay then this will represent a significant benefit for both individual patients and the health system.

University of Otago Papanui turns 800

Day one was ground breaking – 23 Feb 2011, the day after the big Christchurch earthquake.  Today is day 800 of what I lovingly refer to as the Papanui campus of University of Otago Christchurch.  For my children it’s just the office out the front of the house where their father works.  For me, it used to be my workshop & study.  Once upon a time it was computer and telephone free!  That all changed at midday on 22 February 2011 when I and my colleagues were unceremoniously thrown out of the University of Otago Christchurch building (you know the big building at the front of Christchurch hospital with the glass facade with the words “Research Saves Lives” written across it).  My ICU, ED and other medico colleagues went to work immediately, while the rest of us watched the first of the injured arrive at the hospital on the back of utes and sitting in the boots of cars. I hung around until I was sure my students and staff could all get home.  After an hour or so I walked home – first across Hagley park with hundreds of others exiting the city.  I chatted with a woman who got out of Ballantynes and another who escaped the carnage in Cashel Street.  A house not far from my own had partially collapsed – I went on to the property and called out to see if anyone was there.  I got hold of a neighbour who told me that the people who live there both work somewhere in town.  I prayed that they would be OK as they were in for a shock when they returned home.  Eventually I get home.  My family, including the dog, were not there – they had gone looking for me.  All the while the ground kept shaking.  My family returned and we rejoiced in each other’s presence.

My OfficeThe next day I opened my office thinking I may have to work at home for a few days.  My PhD student Dr Maryam Nejat was in touch.  She got home OK, but she was at a loss what to do about her thesis.  It was on her computer at work.  She’d been due to submit it within a month.  Fortunately, I had a laptop at home with a reasonably recent draft.  Maryam came around and we got to work, the first meeting at the Papanui campus.

The Papanui Campus

The Papanui Campus

When the quake hit I’d been in the middle of submitting an article to a journal for consideration for publication.  This too had to be retrieved and resubmitted somehow.  My colleagues involved in lab research suddenly had their facilities unavailable.  They were very concerned about the welfare of the animals.  My somewhat minimal role as group manager took on a new dimension.  Fortunately, those I work with were so very competent.  We discovered the animals had taken great priority and people were in the building feeding and caring for them all the while nobody else went inside.

As we watched the news, prayed for rescues, and held our breath every time the earth moved my thoughts turned to what else I could do.  I was fortunate to live in an area relatively unharmed, apart from the one house I mentioned.  The little liquefaction in the road around the corner had quickly been moved off the footpaths into the gutters and I’d hopped on the roof the neighbour’s house to remove chimney bricks threatening to fall on those below.  No medical skills, no search and rescue skills, no great shakes with a shovel (besides, my family didn’t want me out of sight for a while), I did what I could and went into work, 5 metres from the front door.  After all, Acute Kidney Injury is a great risk in crush victims and while I couldn’t help the people in the Christchurch quake, maybe I’ll do something for other quake victims in the future.

Messages started to come through from the Dean. The building had been yellow stickered for “remedial work”, but it looked like we would only be out of the building for about 4-8 weeks.  In the meantime, we were allowed to enter the building to retrieve essential items (computer!).

After 7 weeks (mid April) we were told occupancy of our offices and labs may not be till July. So I beefed up my broadband allowance.  Then we were told September (2011 remember!).  After that predictions no longer came.  The first staff went back into the building in November 2012, 21 months after the quake.  Nearly all academics (I may be the last left working elsewhere?) are back in the building now, the labs are open, the students are at lectures, the library is moving back in next week, and the Dean’s office should be back in about a month.

So, day 800 and lots to celebrate at the Papanui Campus:  Two PhD theses, 15 journal articles submitted and accepted, 1 book chapter, an ED & ICU study completed, another ICU study data collected, a lab study managed to completion in temporary location, new collaborations with colleagues in Germany, USA, Canada and Auckland, and a couple of online conferences.  An additional bonus has been the joy of working from home and seeing my family throughout the day (my children are Home educated).  Not so thrilling is the dog coming and nudging me when he wants some attention. Scariest moment was the large “after shock” in June 2011 where I held on to the monitor, ducked my head under the desk, and my group director on Skype from Sydney watched my printer fly off a filing cabinet behind me.  Perhaps the most difficult thing for a scientist working alone is the sense of isolation.  Email and Skype only partially ameliorate that.  I also make regular trips into town to visit colleagues and drink coffee.  Of the writing of blogs there is no end, but I have found participating in a couple of online blogging communities has kept me from having too narrow a focus.  How many more days there are for the Papanui Campus I do not know.  Little did I know when I built this Versatile sleepout 12 years ago that it would become a small outpost of Otago University. I don’t expect it will make the official history of the university, but it is now indelibly part of my personal history and I am very grateful that I have been able to work here.

Papanui campus in action. Left to right: Myself, Dr Azrina Md Ralib, Prof Zoltan Endre

Papanui campus in action. Left to right: Myself, Dr Azrina Md Ralib, Prof Zoltan Endre

Happy WKD

I love living in NZ, it enables me to be the first in the world to wish everyone a happy World Kidney Day.  May your kidneys never lack oxygen, be always filtering, and ever distant from the nephrologists biopsy needle!

Let me remind you:

 If it weren’t for your kidneys where would you be

You’d be in the hospital or mortuary

If you didn’t have functioning kidneys

(with apologies to John Clarke)

Better, take a look at this video too (from www.worldkidneyday.org):

This year’s theme for World Kidney Day is “Kidneys for Life: Stop Kidney Attack.”  If you’ve not caught up with my myriad of other posts, Kidney Attack (aka Acute Kidney Injury) is the rapid loss of kidney function and/or structural damage brought about by toxic damage to the kidneys or temporary loss of blood to the kidneys.

This week I published a blank post entitled “A list of effective treatments for Kidney Attack.”  There is no known treatment – merely acute dialysis, a support for the kidneys, not a treatment. There is no treatment because detection is delayed and difficult and because not enough research has been done.

The good news is that I and many others around the world are engaged in finding new ways of detecting this disease.  Before I list some of the good news I want you all to repeat after me “30,000 kidney attacks a year in New Zealand, 1300 deaths.”  If you live out of New Zealand you may say “Two million die of Kidney Attack each year.”  Now tell someone else … anyone … the next person you see (not your boss if you read this at work).  Well done, thank you.

So, for some good news:

Hooray – we have for the first time means of measuring structural damage to the kidneys.  For us, this is the X-ray moment.  Imagine life before the X-ray – all that could be said is that you could no longer bowl a bouncer (throw a curve ball), play the piano, or dance a jig (whatever that is).  In other words, all that could be said was function was lost.  With the X-ray actual injury to the bone could be observed.  Importantly, it could be observed before function was lost permanently.  The measurement of various molecules we make in the urine are to us like the X-ray – they are measures of injury to the kidney (we call them biomarkers).

We are busy investigating how best to use these biomarkers and have been discovering:

  • which are best after Cardiac surgery, Contrast procedures or in the ICU (all risk factors for Kidney Attack),
  • what the optimal timing is for measurement of each biomarker,
  • how to use the biomarkers in Randomised Controlled Trials aimed at testing new treatments,
  • which biomarkers are best for detecting Kidney Attack when someone has additional co-morbidities like sepsis, and
  • which biomarkers add the most value to what we already know and enable the best assessment of risk of poor outcomes.

In the meantime, some of my work has shown how we can better utilise the information we already have with urine output and the mainstay of nephrology, the plasma creatinine measure:

  • the discovery that even when creatinine does not change after Cardiac Arrest there is likely to be Kidney Attack (it had been thought that it was only when creatinine was elevated there was a problem),
  • a combined measurement of plasma & urine creatinine and urine flow rate (called creatinine clearance) over a short period of time in the ICU helps identify Kidney Attack patients otherwise missed,
  • how best to estimate someone’s “normal renal function” so that a judgment can be made if it has recently changed, and
  • how best to utilise creatinine in Randomised Controlled Trials to tell if an intervention is improving kidney function.

All these add up to progress.  My own and my group’s work over the last 6 years has received funding from a number of funders (see logos attached) some of which originate with your tax dollar – hence my commitment to keep the tax payers informed. I am indebted to my boss, Professor Zoltan Endre, not only did her hire me (I think he mistook Physicist to mean Physician!), he has taught me heaps and consequently we have formed a strong collaboration. Our work has also depended on the good staff of Dunedin and Christchurch Hospital ICU’s, Christchurch Emergency Department, and the Canterbury Health Laboratories.  Without the commitment to research these people make, progress would not have been made.  Most important are the patients or their families who have consented for us to take extra samples or enroll them in a trial. The decision to participate is often made at a difficult time – families wrestling with issues of possible death or long term health issues of their loved ones.  I salute them.  I thank them.  New hope, new medicines, new tests, and new procedures are built on the courage and generosity of the patients and families who participate in research.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.