London experiences brain gain with recruitment of respected researcher

Winter 2015

In the 1990’s, many Canadian news outlets chronicled a phenomenon known as ‘brain drain’ – highly educated Canadian workers were emigrating to accept international opportunities. The tides appear to be shifting in London, Ontario within the world of health care research as London now enjoys a reputation as a place where world-class research can thrive. The story of the recruitment of United Kingdom (U.K.) scientist and nephrologist, Dr. Chris McIntyre and four of his research team members to LHSC and Lawson Health Research Institute, demonstrates not only the power of London’s appeal, but how being in the right place at the right time can change the face of health care.

For Dr. McIntyre, one of the most pivotal moments in his career would present itself in a most unexpected way.

After completing his medical training in 2006, he joined a well-respected nephrology department in the U.K. Unfortunately his office did not have ventilation.

“The office looked on to a patient waiting room. I had two choices: sit with the door closed in a stifling, stuffy office or have the door open and work in plain sight of all the patients,” he says.

He decided to keep the door open – and what he saw next surprised him. Consistently, upon arrival, dialysis patients had a healthy complexion – but after treatment, they looked ashen. An inspiration for research began to form as Dr. McIntyre combined this observation with his knowledge of the side effects of dialysis, which include damage to multiple organs such as the heart and brain.

“Normally, the body’s waste products and accumulated fluid would be slowly eliminated over time, but when we dialyze someone we eliminate the wasteand fluids in just a few short hours. This causes a damaging drop in blood pressure,” he says. “The leading cause of death among dialysis patients is cardiovascular disease. So, I asked myself ‘Is the dialysis treatment itself the cause of patients’ cardiovascular problems?’”

This paradigm-shifting concept was new to the medical community and became the base of Dr. McIntyre’s future research.

In studying this novel hypothesis (or question), it began to become apparent that the answer was “yes” and Dr. McIntyre and his team also discovered a simple solution to help decrease the severity of side effects.

“Our group has done a lot of work to help stabilize a patient’s blood pressure during treatment and we looked to build on techniques that were already
established.”

The cooling of the dialysis fluid, or dialysate, has been standard practice for a number of years to help protect patients experiencing blood pressure problems. The team decided to look at ways to enhance his approach and discovered that how they applied the cooling technique made a major difference.

Rather than cooling the dialysate only for patients who were identified as having trouble with blood pressure, Dr. McIntyre and his team applied the technique on all patients. In addition, the dialysate temperature was individualized to each patient’s body temperature to ensure that patients could benefit from the cooling but would not feel cold.

The team was surprised by the response. Not only were they able to reduce short-term injury, but with this simple intervention they were able to protect all of the patients’ other organs, including the brain.

Though Dr. McIntyre’s research had made promisingstrides, the research infrastructure in the U.K. made it challenging for him to take his research to the next level. Then, while at an international kidney conference, he met LHSC’s Dr. Robert Lindsay, a kidney specialist who is world-renowned for his contributions to the science of hemodialysis. The meeting became the catalyst behind Dr. McIntyre’s move to Canada.

“I needed another challenge,” says Dr. McIntyre. “The thought of moving to London, Ontario and working with Dr. Lindsay and his colleagues was very attractive. A lot of the research I do is based on imaging and London is home to some of the best imaging facilities and imaging researchers in the world. Combine this with the excellent kidney program at LHSC and the opportunity was too good for me and my team of researchers to pass up.”

Today, Dr. McIntyre and his team continue to work on improving the side effects related to hemodialysis, with a special focus on the patient experience.

“These patients are stuck between a rock and a hard place – they cannot live without dialysis, but struggle to survive the treatment itself,” says Dr. McIntyre. “Whatever we can do to make dialysis a better and less destructive treatment is important.”

Dr. McIntyre’s clinical practice is located at LHSC’s Victoria Hospital. In addition to his role as a Lawson scientist, Dr. McIntyre is the recipient of the Dr. Robert Lindsay Chair in Dialysis Research and Innovation, and the new Director of the Kidney Clinical Research Unit at LHSC.

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Dr. McIntyre's clinical practice is located at LHSC's Victoria Hospital. In addition to his role as a Lawson scientist, Dr. McIntyre is the recipient of the Dr. Robert Lindsay Chair in Dialysis Research and Innovation, and the new Director of the Kidney Clinical Research Unit at LHSC.