The Vasculitis Foundation welcomes Dr. Jennifer Rodrigues, as our 2016-2017 VCRC-VF Fellow. Dr. Rodrigues completed medical school at the University of Calgary in 2011, her Internal Medicine training at McGill University in 2014, and a Nephrology fellowship at the University of Toronto this past year. She will complete this fellowship under the direction of Dr. Michael Walsh, Associate Professor of Medicine and Clinical Epidemiology & Biostatistics at McMaster University, Hamilton, Ontario
Dr. Walsh said that he is particularly excited to be mentoring Dr. Rodrigues because she is bringing a stellar background in basic immunology and a longitudinal clinical experience to her new role.
“Dr. Rodrigues is highly regarded for her clinical skills, thoughtfulness with respect to her patient’s well-being and attention to detail. These qualities are complemented by her scientific curiosity and highly organized nature,” said Dr. Walsh. “Although I only recently started working with Dr. Rodrigues, her drive to develop the best evidence to guide the treatment of patients with vasculitis is obvious. With the help of the VCRC-Vasculitis Foundation award, Dr. Rodrigues is on the road to becoming a leader in vasculitis research and her contributions will undoubtedly improve the quality of care provided to patients.”
In the following interview with the Vasculitis Foundation, Dr. Rodrigues talked about why her particular focus on nephrology is such a critical area of research. She also shared why the VCRC-VF Fellowship is not only a professional opportunity for her, but believes it could yield valuable research insights that will help vasculitis patients in the future.
Briefly describe the focus of your work.
I am a Nephrologist interested in glomerulonephritis, diseases that affect the filters of the kidneys, the second most common cause of kidney failure requiring dialysis. The kidneys are frequently affected by vasculitis and while there are treatments, including immunosuppressive and anti-inflammatory steroid medications, to initially control the disease and prevent flare-ups, we don’t know how long patients should remain on these medications.
The duration of treatment has to be balanced with the risk of infection, bone fracture, and the impact on a patient’s quality of life. I will study whether long-term treatment with very low doses of medications prevents flare ups of vasculitis without significant side-effects. Opinions about whether low-dose medications, particularly prednisone, work in vasculitis vary dramatically around the world so the information from this study will change how vasculitis is treated no matter what it shows!
Why is this important to people with vasculitis?
Most patients with vasculitis will receive prednisone through the course of their treatment. At high doses, prednisone can control the damage vasculitis causes but, it also increases the risk of infections, bone fractures, and may play a role in cardiovascular disease and has very obvious effects on patient’s quality of life. While most of these side-effects disappear at low doses for most patients, it is not clear whether they continue to reduce the risk of vasculitis flare-ups. Avoiding long-term use may reduce the risk of harmful side effects but it may also increase the risk of disease flare-ups and the damage to organs like the kidney.
How did you decide on your specialty?
My interest in Nephrology began as a teaching assistant in physiology and was solidified during the early clinical rotations of Internal Medicine training where one of my first patients had kidney failure requiring dialysis. It is a diverse specialty combining various areas including electrolytes, dialysis, kidney transplant, glomerulonephritis, and immunology in daily practice. We look after a wide variety of patients, from the sickest patients in the intensive care unit to those in clinic who are living with kidney disease. Every day we are presented with new challenges and the opportunity for an important impact on patients’ lives.
What do you find most challenging about it?
I think the biggest challenge in Nephrology is the need for more studies to better understand the complex diseases that affect the kidneys such as vasculitis, in order to determine the best treatments for our patients.
As a nephrologist, you are focused specifically on studying the impact of vasculitis on the kidneys. Tell us more about the research you will be doing into this area.
With the support of the Vasculitis Foundation, I intend to conduct a pilot clinical trial examining whether long-term low dose prednisone is effective at preventing relapse of ANCA-associated vasculitis and its impact on kidney function with a particular focus on the side effects of prednisone and its impact on patients’ quality of life.
I will study whether long-term treatment with very low doses of medications prevents flare ups of vasculitis without significant side-effects. Opinions about whether low-dose medications, particularly prednisone, work in vasculitis vary dramatically around the world so the information from this study will change how vasculitis is treated no matter what it shows!
Talk about how your research could potentially impact the way that patients are treated with Prednisone in terms of risks vs. benefits to the patient.
Avoiding long-term use of prednisone may reduce the risk of harmful side effects but it may also increase the risk of disease flare-ups and the damage to organs like the kidney. My study will clarify the risks and benefits of low-dose prednisone which will ultimately change the way many patients around the world are treated. Importantly, this study will also help us understand the potential effects of low-dose prednisone in other inflammatory and kidney diseases.
You have said that Glomerulonephritis (GN) is the next big development in our area of study. Please explain Glomerulonephritis and why it needs greater research.
Glomerulonephritis (GN) is a complex and rare disease that is the second most common cause of kidney failure. Specialized clinics, as well as an increase in the amount of clinical research in this area will translate into improved outcomes. There are many types of GN in addition to vasculitis, and these patients frequently receive long-term immunosuppressive medications to control their disease.
Determining how long these patients should remain on immunosuppression once their disease is in remission in order to balance medication side effects and impact on patient’s quality of life with the risk of disease relapse is an important research question.
Personally, what does this VF Fellowship mean to you? How do the VF Fellowships advance our understanding of vasculitis?This fellowship will provide me with the opportunity to improve the care provided to patients with vasculitis. I am fortunate to have many excellent mentors within the field of vasculitis and glomerulonephritis and to be among the many previous successful recipients of this fellowship.
The Vasculitis Foundation has been critical to representing patient interests, raising awareness about these diseases, and helping to set research goals.
What is the most rewarding about your work?
It is a privilege to look after patients with kidney disease as we are often able to treat them when they are very ill in the hospital and then follow them over time in the clinic after they improve. We also look after a wide variety of patients of all ages and with a variety of conditions. We see patients with very aggressive types of vasculitis that can cause kidney failure and to be able to offer effective therapy is very rewarding.