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Tyrone Harrison, MD

Supervisor: Dr. Brenda Hemmelgarn
Award: KRESCENT Post-Doctoral Fellowship
Institution: University of Calgary
Year: 2019-2022

Study title: Improving the perioperative care of patients with end-stage renal disease

Dr. Harrison received his medical degree from the University of Calgary in 2013, which was followed by residency training in Internal Medicine and Nephrology (completed in 2018). Dr. Harrison has now begun his doctoral studies at the University of Calgary by pursuing a PhD in Health Services Research, as part of the Clinician Investigator Program. He is completing this training with supervisor and clinician-scientist Dr. Brenda Hemmelgarn. His research, while a KRESCENT post-doctoral fellow, is focused on understanding and improving the perioperative management of patients with end-stage kidney disease.
Lay Summary
In Canada, approximately one in nine adults have a surgical procedure each year, and of those, one in twenty have a major cardiovascular event (heart attack, heart failure, stroke etc.) around the time of surgery. These cardiovascular events around the time of surgery have significant implications with one third of cases resulting in death, in addition to prolonged hospitalization, and increased health care costs. End-stage renal disease (ESRD), or kidney failure, requires either kidney transplantation or dialysis initiation as life sustaining therapy. Patients with ESRD have an overall risk of cardiovascular death 10-20 times that of the general population. Despite this high risk, little is known about the risk faced by ESRD patients around the time of surgery, and how best to detect individuals at highest risk. Recommendations from current Canadian guidelines include risk scores and blood tests to be drawn prior to surgery, but these tools are not well-understood in patients with ESRD.
Research is needed to provide care for ESRD patients that is specifically designed for use in this important patient population. With this KRESCENT supported research, Dr. Harrison will first characterize predictors of post-operative cardiovascular events and death in ESRD patients in a population-based cohort of patients, which will lead to development of an ESRD-specific risk prediction model for use in the perioperative period. Finally, patients and perioperative experts will be consulted to identify consensus-based best-practices to be incorporated into perioperative pathways for the care of ESRD patients. Ultimately, if researchers are able to understand and predict the risk of ESRD patients around the time of surgery, the developed ESRD care pathway will reduce and prevent unnecessary and potentially life-threatening cardiovascular events for patients.