Alexander L. Bullen

Acute Kidney Injury

Acute kidney injury (AKI) is a major therapeutic challenge. One of the potential reasons for this, is the difficulty in obtaining an adequate and comprehensive assessment of the renal function. I recently performed a study with my group where I evaluated markers of kidney tubular function to determine if patients with underlying kidney disease and decreased tubular function at baseline were at higher risk of acute kidney injury. I found that two markers of kidney tubular function at baseline can predict future risk of acute kidney injury secondary to hemodynamic changes among patients with chronic kidney disease. My currently goal is to determine if a broader panel kidney function markers are also able to detect future risk of AKI and to expand my currents findings to diverse forms of AKI.

Intradialytic Hypotension
Intradialytic hypotension is the most common complication during dialysis. It has been associated with cardiovascular disease, decreased cerebral blood flow, poor quality of life and it is an independent risk factor for mortality. Our work has demonstrated that decreasing the dialysate temperature in an individualized manner is not only an effective technique to decrease intradialytic hypotension, but it is also well tolerated. 

Quality of Life Among Hemodialysis Patients
End stage renal disease or advanced kidney disease requiring dialysis is associated with depression, anxiety, sexual dysfunction and sleep which can impact health-related quality of life. Acupuncture and massage are complementary nonpharmacological interventions that have been used to manage symptoms of chronic illness and reduce their severity. Our work revealed that use of complementary therapies such as massage and acupuncture during hemodialysis may contribute toward improvement of health-related quality of life and thus should be considered when addressing overall health status of these patients. 

Recent Original Publications or Review on Topic Include:
Bullen AL, Katz R, Lee AK, Anderson CAM, Cheung AK, Garimella PS, Jotwani V, Haley WE, Ishani A, Lash JP, Neyra JA, Punzi H, Rastogi A, Riessen E, Malhotra R, Parikh CR, Rocco MV, Wall BM, Bhatt UY, Shlipak MG, Ix JH, Estrella ME.  Markers of Kidney Tubule Cell Function and Injury and Risk of Subsequent Acute Kidney Injury: The SPRINT Trial. Kidney Int., 2019; In Press

Bullen AL, Anderson CAM, Hooker ER, Kado DM, Orwoll E, Pasch A, Ix JH. Correlates of T50 and relationships with bone mineral density in community-living older men: the osteoporotic fractures in men (MrOS) study. Osteoporos Int. 2019

Bullen A, Rifkin D, Trzebinska D. Individualized Cool Dialysate as an Effective Therapy for Intradialytic Hypotension and Hemodialysis Patients' Perception. Ther Apher Dial. 2019 

Bullen A, Shah MM. De Novo Postinfectious Glomerulonephritis Secondary to Nephritogenic Streptococci as the Cause of Transplant Acute Kidney Injury: A Case Report and Review of the Literature. Case Rep Transplant. 2018

Bullen A, Awdishu L, Lester W, Moore T, Trzebinska D. Effect of Acupuncture or Massage on Health-Related Quality of Life of Hemodialysis Patients. J Altern Complement Med. 2018 

Bullen A, Liu ZZ, Hepokoski M, Li Y, Singh P. Renal Oxygenation and Hemodynamics in Kidney Injury. Nephron. 2017

Liu ZZ, Bullen A, Li Y, Singh P. Renal Oxygenation in the Pathophysiology of Chronic Kidney Disease. Front Physiol. 2017