Dr. Thomas Mavrakanas
Associate Professor - Department of Medicine
My research focuses on the causes of and treatments for cardiovascular disease in patients with advanced chronic kidney disease (CKD), across two main axes: a) cardiorenal interactions, and b) anticoagulation and thromboembolic disease in CKD. I have significant expertise in designing pharmacokinetic or observational studies and in designing and conducting clinical trials. My work aims to optimize management of patients with CKD and cardiovascular disease in order to prevent occurrence of myocardial infarction, stroke, or admission for heart failure, as well as to slow down CKD progression to kidney failure.
1. Canagliflozin in patients with advanced renal disease with cardiac MRI endpoints (the CARe-MRI clinical trial, NCT06182839). This randomized controlled trial will study the effect of canagliflozin on cardiac structure and function in patients with advanced CKD, including those on maintenance dialysis.
2. Effect of canagliflozin on peritoneal function & fibrosis in patients on peritoneal dialysis (the CAN-PD clinical trial). This crossover randomized trial will study the effect of canagliflozin on glucose absorption, ultrafiltration, inflammation, and fibrosis in patients with kidney failure on peritoneal dialysis.
3. Identification, description, and prognostic significance of latent classes based on hemodynamic indicators for patients on maintenance hemodialysis. This retrospective cohort study will identify distinct phenotypes of blood pressure response among patients undergoing maintenance HD and study the association of each phenotype with hard clinical endpoints.
4. Predictors and clinical significance of stroke and bleeding in maintenance dialysis. This retrospective cohort study will describe the clinical significance of stroke and major bleeding in patients on maintenance dialysis and identify the attributable risk of stroke in patients with atrial fibrillation and kidney failure.
5. The Diuretic Resistance in Patients with Acute Heart Failure study 1 (DRIP-AHF-1, NCT05305495). This prospective, interventional, single arm study is assessing the potential synergistic diuretic effect of empagliflozin to furosemide in patients with acutely decompensated heart failure and diuretic resistance.