Dr. Michael Reaume
Supervisor(s): Dr. Navdeep Tangri
Award: KRESCENT Post-Doctoral Fellowship
Institution: Chronic Disease Innovation Centre
Year: 2026-2028
Project Title: Can we put chronic kidney disease into remission?
Topic(s): Chronic Kidney Disease
Biography
Dr. Michael Reaume is a research fellow at the University of Manitoba. He received his MD from the University of Ottawa and an MSc in Biostatistics from Queen’s University. He completed Core Internal Medicine residency at the University of Manitoba and Nephrology fellowship at the University of Ottawa. His work focuses on chronic kidney disease epidemiology, health equity, and health services research, with the goal of improving outcomes for people living with kidney disease.
Lay Summary
Background: Chronic kidney disease (CKD) happens when the kidneys are damaged or do not work properly for at least three months. CKD is common, affecting about 1 in 7 adults in the world. CKD can cause serious health problems such as heart attacks, heart failure, and strokes. CKD can also cause kidney failure, which means that the kidneys stop working. This is a serious condition that requires dialysis (a machine that cleans the blood several times per week) or a kidney transplant. Diabetes is the most important risk factor for CKD. Diabetes causes one-third to one-half of all cases of CKD, and about 40% of people with diabetes will develop CKD during their lives. In the past, doctors thought that CKD in people with diabetes always got worse over time. Specifically, they believed that people with CKD and diabetes gradually lost a bit of kidney function and developed more protein in the urine (another sign of kidney damage). Today, there is much more hope due to four types of kidney-protective medications (RASi, SGLT2i, nsMRA, and GLP1-RA) that have greatly improved the health of individuals living with CKD and diabetes. Researchers first developed these medications to treat conditions like diabetes and high blood pressure, but we now know that they also protect the heart and kidneys. When people take these medications together, their kidney function may stop getting worse. But these medications are not perfect and can cause side effects, like high potassium levels in the blood. Doctors sometimes use the word “remission” when a disease is inactive or under control. For example, cancer can sometimes go into remission with treatments. But doctors have not yet agreed on what remission means for people with CKD. This is a problem, because without a clear definition, we do not have clear treatment goals for people with CKD.
Purpose: Right now, doctors cannot tell patients when their kidney disease is inactive or under control. Our goal is to change this. We want to define what “remission” means for people with CKD. We also want to set clear treatment targets so that patients and doctors know what to aim for.
Methods: Our study has three parts. In Part 1, we will describe how common CKD is in Canada. We will also determine how many people with CKD are taking kidney-protective medications. To answer this question, we will use survey data recently collected by Statistics Canada between 2022 and 2024. In Part 2, we will identify and describe patients whose kidney disease went into remission (which, for our study, means that their kidney function stopped getting worse and that protein stopped leaking into their urine). We will search provincial health records to find these patients. In both parts 1 and 2, we will first study all people with CKD, then focus on people with both CKD and diabetes. In Part 3, we will look for early signs that kidney-protective medications are working. To do this, we will analyze data from two clinical trials (studies where researchers test new treatments on patient volunteers) involving patients with CKD and diabetes who received new kidney-protective medications.
Anticipated outcomes: We expect to learn four important things. First, CKD is becoming more common. Second, many people with CKD are not receiving kidney-protective medications that could help them. Third, some people with CKD can achieve remission of their kidney disease. Fourth, we can identify when kidney-protective medications are working, and when patients may benefit from adding other kidney-protective medications.
Patient engagement: We will partner with people who have CKD in Manitoba. They will help us understand our findings and translate them so that they can be shared in ways that are clear and useful for patients and their families.
Conclusion and relevance to patients/community: New medications have dramatically improved the health of people with CKD. But despite this breakthrough, doctors still do not have clear treatment targets when caring for patients with CKD. We want to fix this. We want to define remission in CKD, and we want to set treatment targets so that patients and doctors know what to aim for. We think that instead of simply trying to slow down kidney disease, patients and doctors should aim for remission. Our goal is to provide clear definitions and treatment targets to help patients and healthcare providers across Canada, including family doctors, who care for most people with kidney disease.