Stem cell potential

Acute kidney injury affects one in five intensive care patients. A staggering fifty percent of those patients will not survive.

Doing the rounds of the intensive care unit several years ago, nephrologist Dr. Kevin Burns was struck by the number of patients with acute kidney injury. While they had come to intensive care for other serious illnesses, experiencing low blood pressure, shock, infections, blood loss after an operation, or needing to take certain medications, had injured their kidneys.

“Despite ongoing research in this area for over 60 years, there is no treatment,” said Dr. Burns. “Things have been tried to help the kidneys recover and absolutely nothing has worked to date.”

That is until now. Dr. Burns and his fellow researchers at The Ottawa Hospital Kidney Research Centre are uncovering ways to help kidneys recover from injury and to prevent it from happening in the first place.

Dr. Kevin Burns
Nephrologist and senior scientist Dr. Kevin Burns is investigating how stem cells could regenerate kidneys after acute kidney injury.

Chronic kidney disease – preventative research and early treatment

While exciting progress is being made in treating acute kidney injury, researchers at The Ottawa Hospital are also looking into ways to improve detection and treatment of chronic kidney disease.

“If we can catch the disease earlier, treatments will be more effective at preventing or delaying kidney failure. Any way that we can buy time and prevent or delay losing kidney function will be invaluable to patients,” said researcher Dr. Dylan Burger, a world expert laboratory scientist at The Ottawa Hospital’s Kidney Research Centre.

He is developing a diagnostic test that can predict if a person is at risk for developing kidney disease rather than relying on the current tests which show when it is already present, often at an advanced stage.

World-first technique for early detection

In the lab, Dr. Burger’s team looked at what happens at the cellular level when people start to develop kidney disease and identified microparticles as the problem. These are tiny pieces that come off a cell when it’s stressed or injured and are released into the blood or urine causing damage to the kidney.

In response to this finding, the team has developed a technique to count microparticles in urine. This technique, which is still in the research phase, allows any patient’s urine to be tested to accurately determine their risk for developing kidney disease.

The results of this approach have been published and it is now being used in approximately 20 different labs around the world. A standardized technique is being developed so that any lab in the world can use the same diagnostic test for patients.

Dr. Dylan Burger with student Ozgun Varol
World expert laboratory scientist Dr. Dylan Burger watches student researcher Ozgun Varol.

World-class expertise

These studies are only part of the kidney research taking place at the Ottawa Hospital. As one of Canada’s largest health research centres, researchers and clinicians have tremendous opportunity to learn from each other and work collaboratively to bring treatments from the lab to the bedside.

The expertise of these scientists, the quality of their kidney research, and the number of publications is attracting researchers from around the world. This level of excellence and a resolve to remain at the forefront of research and discovery will directly translate into improved treatment and outcomes for patients.

To learn more about the leading research of The Ottawa Hospital and the life-changing innovations that are improving patient lives, please click here.

June Jones lives a double life. During the day, she is busy, making cookies with her two granddaughters, working in her garden, and enjoying life. During the night, she sleeps hooked up to a dialysis machine. June needs a new kidney.

June making cookies after Christmas with her granddaughter Leah.
June making cookies after Christmas with her granddaughter Leah.

The 58-year-old has been living with kidney disease for 30 years — over half her life.

In April 1989, not long after her second child was born, June felt extremely run down. Her physician was concerned she had too much blood in her urine and sent her to a nephrologist.

He diagnosed her with IgA nephropathy, disease caused by her body’s immune system attacking her kidneys.

June started on various medications after being diagnosed, but within nine years her disease had progressed, and her kidneys stopped working completely. She started dialysis in 1998.

“There is no cure for renal disease,” said June. “Once your kidneys fail, you’re put on dialysis or have a transplant. Your life is never normal.”

What kidneys do

The function of the kidneys is to remove waste and extra water from the blood to make urine. When kidneys stop working and no longer clean the blood, toxins accumulate in the body, and this can be fatal. Dialysis is an artificial method of cleaning the blood. It sustains a person’s life but is not a cure.

There are two different forms of dialysis. Hemodialysis removes waste products and extra water from the blood by circulating and filtering it through a machine. This is the most common form of dialysis that is often provided to patients at the hospital. Peritoneal dialysis circulates a fluid through the lining of your abdomen, or peritoneum, and the waste products from the blood pass into this fluid.

There are almost 1,000 patients on dialysis in the Ottawa area. Just over two hundred are on peritoneal dialysis. Dr. Brendan McCormick, Medical Director of the Home Dialysis Program, said some patients have been treated for over a decade on peritoneal dialysis but more typically patients spend about three years on this therapy. People leave peritoneal dialysis once they receive a kidney transplant, however, some need to transfer to hemodialysis due to complications of therapy.

The Ottawa Hospital Home dialysis program has the highest rate of kidney transplant in the province. For many patients, peritoneal dialysis serves as a bridge to kidney transplant.

Needing life-saving dialysis

According to a report by the Canadian Institute for Health Information released in December 2018, only 16 percent of Canadians on dialysis survive past 10 years. However, up to 74 percent of Canadians with a kidney transplant still have a functioning kidney after 10 years.

June was only on dialysis for six months before she received the call that a donor match had been found. On November 28, 1998, June received a kidney transplant from a deceased donor.

“It lasted four months shy of 15 years,” June said. “Then, the disease reappeared. I’ve been back on dialysis now for six years.”

In the Ottawa Region, 52 people have received kidney transplants this year. Unfortunately, there are still 165 people are on a waiting list.

“We need to do a lot of transplants to get people off dialysis to keep them alive longer with a better quality of life,” said Dr. Ann Bugeja, nephrologist and Director of the Living Kidney Donor Program. “We know that getting a living donor kidney is the best treatment for end-stage kidney disease and it lasts longer than getting a kidney from a deceased donor.”

When June’s kidney transplant failed six years ago, she had to go back on hemodialysis. She switched to peritoneal dialysis in July 2013. Once again, she has a dialysis machine at home, but this time she does dialysis for nine hours every night. It cleans her blood while she sleeps.

June’s nightly routine is a hassle and not a permanent solution. The membrane around her stomach has started to harden, which means the fluids can’t move back and forth as easily. What this means is that June will have to go on hemodialysis. The technology hasn’t changed in the 20 years since she was on it before and she remembers too vividly how it gave her severe headaches and was painful.

 

Making a difference for future generations

The Joneses at the unveiling of the plaque outside the Jones Family Foundation Kidney Research Laboratory in honour of their million dollar donation to Kidney Research.
Russ and June Jones with their family at The Ottawa Hospital. The Jones family made a $1 million donation to support kidney research at The Ottawa Hospital.

Russ and June Jones with their family at The Ottawa Hospital. The Jones family made a $1 million donation to support kidney research at The Ottawa Hospital.

June needs a new kidney. She is on a Canada-wide waiting list for one.

“Giving a kidney can change somebody’s life,” said Dr. Bugeja.

June lives with the daily hope of a second transplant.

She and husband Russ know first-hand how important research is to improve outcomes for people suffering with kidney disease. They heard researchers at The Ottawa Hospital were making great strides finding solutions to kidney diseases, including detecting kidney disease early and looking at the potential of stem cells to heal injured kidneys.

They decided the only way to make a difference for future generations of patients was through research and made a $1 million donation to support kidney research at the Kidney Research Centre at The Ottawa Hospital.

Their support will enable the research team at the Kidney Research Centre to continue to advance knowledge and improve the care of patients with kidney disease through world-renowned studies and research.

June’s children are now adults, married, and parents themselves — each with their own adorable little girl. Leah, aged two, and Bailey, 18 months, are the pride and joy of June’s life.

On January 8, 2019, the entire family was at The Ottawa Hospital Kidney Research Centre to unveil a plaque outside the Jones Family Foundation Kidney Research Laboratory. The plaque commemorates their incredible support of kidney research.

“I hope with research advancements, I will live to see my grandchildren’s memorable events,” said June.

“I hope to be there for their high school graduations, university graduations, their wedding days, and when they have children of their own. I also hope great strides are made so that their generation will find a cure.”

Listen to Pulse podcast and hear June Jones in her own words explaining what it’s like waiting for a second kidney transplant and why research is so important.

Phil and his son Sean
Sean donated a kidney to his father.

“How old will I be when I give you my kidney?” Seven-year-old Liam asked after his father, Sean Downey, donated a kidney to his father. 

Young Liam knew intuitively that giving was part of the Downey philosophy.

Phil Downey, Sean’s father, said he always knew growing up in rural Carp that helping others was important. It was something you just did. He said his mom, who was a nurse at the Civic Hospital in the 1940’s, kept a poem about giving’ that she’d cut out of a greeting card. It was always on the fridge to remind them how important giving to others was. Phil said a copy of that same poem is stuck on his own fridge today. As well, every one of his five adult children have the poem hanging in their house. It is their family creed. 

“I think it’s important to give, if you have the ability to give,” said Sean. “We live in the greatest country in the world, and have the ability to give more so than a lot of other places in the world. If everybody had that mentality, the world would be a better place.”  

About 12 years ago, Phil was diagnosed with kidney disease, which eventually led to kidney failure. Around the same time, Phil was diagnosed with prostate cancer. After the surgery to remove his prostate gland, he was encouraged to wait five years before having a kidney transplant because Phil would need to take anti-rejection drugs, which suppress the immune system and increase the potential for cancer.  

Five years later, Phil was still cancer free, but he was on dialysis and desperately needed a kidney.  Gail and his children and step children “threw in the hat,” and volunteered to donate their kidney. Sean, his second son, was the best match.  

“A lot of people get cancer or other terrible diseases. I have friends who lost loved ones, and who would’ve cut their right arm off to save someone they love,” said 42-year-old Sean. “There is the medical know how with kidney disease to save one person’s life, and the other person goes on to live a normal, happy life.” He said he just saw donating one of his kidneys as “something you do for your father.” 

The Downey family in their garden.
The Downey Family at their fundraising cocktail event in August 2018. Left to right: Sean Downey, Karen Leonard, Bruce Downey, Shannon Downey, Kevin Wolfe, Bryan Buchanan, Kate Wolfe, Jessica Wolfe, Phil and Gail Downey, centre, with Liam Downey
Gail and Phil with their medals.
In April 2019, Phil and Gail Downey were awarded the Governor General’s Sovereign’s Medal for Volunteers.

In July 2013, Sean and Phil underwent surgery at the same time. The kidney transplant was a success. Phil began to feel better almost immediately. He said he had more energy while still in the hospital than he’d had in years. Recovering together, was great bonding time for Sean and Phil. The father and son had friendly competitions to reach milestones: who could be out walking more; who could do the most, physically or do it the fastest. Over the course of healing together, Phil convinced Sean to join his real estate business. He did, and father and son now work together.   

Phil and Gail were so grateful for the wonderful care he received over the years at The Ottawa Hospital that they actively fundraised for critical hospital priorities, such as the CyberKnife, the new Charlie and Claudette Logue Dermatology Centre, and the Rose Ages Breast Health Centre. They realized that philanthropy was also important to their adult children. The family decided to encourage their friends to inspire generational giving in their families too.  

In August, Phil and Gail hosted a cocktail reception in their backyard with their family, and invited their close friends. They announced, in gratitude for the treatment and care Phil received at The Ottawa Hospital, they would make a significant donation to kidney research. Knowing that the hospital had touched everyone in attendance, the Downeys asked their friends to also consider engaging their own children – the next generation – to support world-class patient care at The Ottawa Hospital. 

The Downey family is paying it forward, knowing their legacy will be shaping the future of health care in Ottawa for generations of Downeys to come.

When Annie and Hernan moved to Ottawa, they had two suitcases, a toddler, and $500 in their pockets.

Annie became Chief Financial Officer of The Ottawa Hospital Foundation. Over the years, she saw first-hand the importance of life-saving care: when a rare virus devastated her kidneys and put her on dialysis, the doctors at The Ottawa Hospital fixed her up. And, Hernan received a successful corneal transplant there.

“I noticed that a growing number of people in and around Ottawa were leaving gifts in their wills to the Hospital. Even though this type of giving doesn’t usually generate much attention, I came to learn what an important source of revenue it is to clinical research, the purchase of medical equipment and the delivery of world-class patient care.”

So, around the time that Annie’s kidney disease was resolved, the couple decided to include a gift to The Ottawa Hospital in their estate plans.

They didn’t think much on it until 2015, when Hernan was diagnosed with appendiceal cancer (or cancer of the appendix, a very rare form of cancer). The Ottawa Hospital was there once again. He fought with everything he had. Tragically, the cancer won, taking Hernan’s life in the end.

Today, Annie misses Hernan terribly–but she does her best to live life to the fullest, like her husband would have wanted. And, she knows that his legacy of kindness and community lives on, thanks to the gift in their will.

“When I look back on my life, I think of me and Hernan as a pair. We have built so much–and we will leave so much. We made beautiful, bright children. We worked hard for the betterment of others. And, we left our bequests to The Ottawa Hospital Foundation, so that those who follow us will receive the best possible healthcare when they need it most.”