My primary research interests are:
I am primarily interested in improving the delivery and methods of peritoneal dialysis, as part of improving delivery of care and increasing accessibility to the therapy in both resource-rich and resource-limited settings. Use of PD in Lebanon is centralized through a unique setup with a private vendor, which may offer advantages but needs to be formally studies as to outcomes, cost, growth and satisfaction. A study is being launched soon having secured access to the rich dataset spanning over 2 decades from the vendor under AUB auspices and governance by its IRB. Findings should help guide advocacy efforts for PD on a larger scale especially in low-resource settings, Given that 15 million patients in need of kidney replacement therapy will not have access to it in 2030 worldwide, solutions such as cheaper PD has been a focus for both the International Society for Peritoneal Dialysis and the International Society of Nephrology.
I have maintained a long-standing interest in optimizing the care of patients with chronic kidney disease (CKD) with particular focus on anemia management and CKD-MBD, and on the transition to the renal replacement therapy phase. Another long-standing interest has also been on Gadolinium-based Contrast Agents and their use in renal patients, focusing on risk reduction and updating policies, watching for any new adverse events now that Nephrogenic Systemic Fibrosis has essentially disappeared.
More recently, and with some funding becoming available, I rekindled our group's interest in studying glomerular diseases and the genetic basis for familial clustering we commonly seen in our practice at AUB, caring for patients from Lebanon as well as from surrounding countries with even higher consanguinity rates. A project has now moved to execution phase starting with establishment of a registry. A large number of biopsies have been sent to Yale for Electron Microscopy evaluation since 2012 which provide strong basis for diagnostic accuracy. Collaboration is planned with the Nephrology team at Yale as work progresses. Similar work was started for Polycystic Kidney Disease with an already launched prospective registry.
Finally, and with the clear benefit of using SGLT2 inhibitors in CKD, including in non-diabetic patients, a study is being readied to examine barriers to the use of this new class of medications, through AUBHealth-EPIC.
Gadolinium; Hypertension; Peritoneal Dialysis; Chronic Kidney Disease-Mineral and Bone Disorder; Nephrogenic Fibrosing Dermopathy