Programme visant à améliorer le diagnostic et les conséquences à long terme de l'insuffisance rénale aiguë chez les enfants

 

Michele Zappitelli

Institut de recherche du Centre universitaire de santé McGill

 

Domaine : nutrition et métabolisme

Programme chercheurs-boursiers cliniciens - Senior

Concours 2015-2016

Acute kidney injury (AKI) is kidney damage that usually happens when patients are hospitalized. AKI is common in children in the intensive care unit (ICU). Unfortunately, the blood tests we use to diagnose AKI change too slowly, so we "miss the boat" to treat AKI, causing many complications. Also, we don't know how we should follow-up these children, after hospital discharge. This is important to know because in adults, AKI causes permanent kidney damage. One of the important long-term "kidney" outcomes after AKI, is hypertension (high blood pressure), a well known cardiac disease risk factor; but it is still unclear how mild-moderate hypertension affects children in the long-term.

Our projects will help address these unknowns: how to better diagnose child AKI, understand AKI long-term outcomes and how hypertension affects the heart. We will study children admitted to the ICU and children treated for cancer in 2 cross-Canada studies, from when they are hospitalized to 3 years later. We will collect urine and blood in hospital to find better AKI diagnosis tests and during follow-ups, we will measure their kidney function and blood pressure. In 2 other long-term studies, we will follow up children 6 years after their ICU stay to perform kidney follow-up.

Finally, in a group of Quebec children recruited from schools ("QUALITY" cohort), we will perform a 24-hour blood pressure test and heart ultrasound, to know how blood pressure level impacts on cardiac risk. The knowledge we gain will allow for us to perform future treatment trials of child AKI (better diagnosis tests, earlier treatment) and will tell us what sorts of long-term kidney and non-kidney outcomes we should follow in these children, to reduce their risk for long-term kidney and cardiac disease.