Neeraj Dhaun (Bean)
Professor of Nephrology; Honorary Consultant Nephrologist; Director Edinburgh Clinical Research Facility
Address
- Street
-
The Queen's Medical Research Institute
47 Little France Crescent
Edinburgh BioQuarter - City
- Edinburgh
- Post code
- EH16 4TJ
Research summary
My group’s research focuses on the cardiovascular risk associated with the spectrum of chronic kidney disease (CKD) from early in the disease trajectory through to kidney failure requiring either dialysis or kidney transplantation. We perform pre-clinical and experimental medicine studies as well as investigating cardiovascular risk at a population level. Our goals are to identify cardiovascular risk early in patients with CKD, to investigate novel therapies that might reduce this risk and so improve longer-term patient outcomes.
Project activity
Current Pre-clinical Projects
1. The role of innate immunity in hypertension & end-organ injury Using macrophage depleting and modifying strategies we are investigating the role of this very plastic cell in the development and complications of hypertension. We use a number of mouse models of disease including high salt diet, endothelin-1 infusion and angiotensin II infusion.
2. The transition from acute kidney injury (AKI) through to CKD Using mouse models of ischaemia-reperfusion injury, we are investigating the cardiovascular and renal sequelae of AKI and examining new experimental medicine strategies to reduce the risks of developing these.
Current Clinical Projects
1. Chorioretinal thinning in kidney disease Using optical coherence tomography (OCT) we have recently shown that the retina and choroid are thinned in patients with CKD and this thinning relates to the degree of kidney dysfunction as well as inflammation and endothelial dysfunction. We are now exploring the utility of these OCT measures as potential clinical biomarkers and as short- and medium-term endpoints in clinical trials.
2. The role of apelin in CKD Apelin is a novel vasodilator peptide and the most potent inotropic agent discovered to date. The apelin system is widely expressed in the kidney. We are studying the effects of apelin on systemic and renal haemodynamics and endothelial function in healthy volunteers and in patients with CKD. Our studies will determine whether apelin could provide additional renoprotective and cardioprotective effects in optimally managed patients with CKD.
3. Utility of PET/MR in large vessel vasculitis Large vessel vasculitis (LVV) is a multi-system, autoimmune disease characterised by non-specific symptoms, pain, and high glucocorticoid requirements. The lack of a robust biomarker makes disease monitoring difficult leading to both over- and under-treatment. We are investigating the ability of positron emission tomography with magnetic resonance imaging (PET/MR) to reliably monitor LVV disease activity longitudinally.
4. Therapeutic potential of endothelin receptor antagonism in ANCA-associated vasculitis ANCA-associated vasculitis (AAV) is a rare, autoimmune disease that commonly involves the kidney. Although current treatments have improved the short-term prognosis of AAV, these patients remain at a significantly increased risk of cardiovascular disease. Endothelin-1 (ET-1) is the most potent endogenous vasoconstrictor with additional pro-inflammatory and pro-fibrotic properties. We are examining if short- and long-term ET receptor blockade will reduce cardiovascular risk in optimally managed patients with AAV.
Current Data Science Projects
1. Temporal trends of cardiovascular disease and treatment gaps in patients with kidney failure Cardiovascular disease is the commonest complication of kidney disease and cardiovascular risk is greatest in those with kidney failure. In population-based studies utilising high-fidelity linked healthcare data unique to Scotland, we are investigating temporal trends in the incidence and outcomes of cardiovascular disease, including rates of secondary prevention prescribing, in patients with kidney failure.
2. Utility of cardiovascular biomarkers in patients with kidney disease Using large datasets, we are investigating the role of high-sensitivity troponin I (and other cardiovascular biomarkers) as a measure of outcome in patients with CKD and those undergoing kidney transplantation.
Funding British Heart Foundation Chief Scientist Office Kidney Research UK Medical Research Council