Supported Research

Lay Abstract

People with kidney failure have up to 16 times more surgeries than people without kidney disease. They also have worse outcomes after surgery including a higher risk of heart attacks and death. Canadian healthcare guidelines recommend that healthcare providers use tools, called risk prediction models, to estimate risk of these negative outcomes. This can be helpful for patients and their healthcare teams. By understanding what to expect after surgery, patients can use this information to make important decisions about whether to have the surgery and which strategies to use to limit the risks. Current risk prediction tools do not work well for people with kidney failure, and the tools that are available may not be predicting outcomes that are important to patients. Current surgery research for people with kidney disease focuses on outcomes that doctors and researchers think are important. We do not know what outcomes after surgery are important to people with kidney failure. Once the priorities of patients and caregivers are identified, research can be done to learn more about these outcomes and understand if tools should be developed to predict the risk of those outcomes. It is likely that some outcomes after surgery, such as length of stay in hospital or outcomes related to rehabilitation and physical function, are more important for those with kidney failure. In this project, we are trying to identify what is most important to people with kidney failure as they have surgery, study these important outcomes, and develop a tool to predict the risk of an important outcome. Methods: Our research team has extensive experience doing patient-focused research, research on surgery and kidney health, and risk prediction research. Two of our core research team members are trained and experienced patient partners, each with a personal history of kidney failure and past surgery experiences. They will guide the direction of these three studies, with the support of other team members: Study 1: Identifying which outcomes after surgery are most important for patients. Our first task is to gather a group of patients with kidney failure who have had surgery, their caregivers (including family members), along with healthcare providers and researchers that work in this field. We will then brainstorm with our research team, recruited participants, and from the available research already published, to identify all surgery outcomes that may be relevant for this group. With this list, we will include all participants through several rounds of surveys and as a group, come to an agreement about which outcomes that are most important after surgery. We will compare the priorities of participant groups, to see whether patients prioritize different outcomes as being important compared to doctors, researchers, and others. Study 2: Studying important outcomes after surgery for people with kidney failure in Canada. After the survey study, we will decide as a team which of these prioritized outcomes have not been researched enough within kidney failure groups by performing a review of the available research. We will use this to decide which three outcomes we will study within Alberta. We will compare the risk of these important outcomes between people with kidney failure and others, to see if people with kidney failure have higher risks. Study 3: Developing a tool to predict the risk of important surgical outcome(s) for people with kidney failure. After studying the risk of important outcomes in Alberta, as a team we will identify which outcome(s) we will develop one or more new risk prediction model for. This tool will be designed specifically for people with kidney failure having surgery and will involve using provincial health data from kidney failure groups in Alberta and Manitoba. Conclusion: We can improve outcomes for people with kidney failure having surgery, but current research has not been guided by the priorities of people living with kidney failure. This work will address this need, by identifying and researching outcomes that are important to patients, and developing tools specifically for people with kidney failure that can be used to predict the risk of these outcomes. Once these tools are developed, we can test them to see if they improve the experience or outcomes of people with kidney failure having surgery.