2022/Feb/26 "But I know all about love already. I know precious little about kidneys" ~Huxley

Brain-Kidney Connection

Dearbhla Kelly is an Irish Nephrologist and currently serves as an NIH StrokeNet Fellow at the Massachusetts General Hospital. She is also a Senior Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute, Trinity College Dublin. She has a DPhil from the University of Oxford. Her research interests include the epidemiology of stroke in patients with chronic kidney disease. She is also interested in cognitive disorders in patients with kidney disease, and the impact of blood pressure on brain health. As an International Society of Nephrology (ISN) Global Kidney Health Atlas Fellow and a member of the ISN Emerging Leaders Program, she is excited to participate in international studies and to contribute to policy development and advocacy for patients with kidney disease.

I sat down with Dearbhla over a cuppa to ask about her work and what brings her to Boston.

Dr Dearbhla Kelly

STANLEY:
What brought you from Britain to Boston?

KELLY:
My DPhil focused on the risks, mechanisms, and outcomes of stroke in patients with chronic kidney disease (CKD). I came to Boston to do a postdoctoral research fellowship with Anand Viswanathan at the Massachusetts General Hospital Stroke Research Center to study the intersection of CKD and cognitive brain health, which seemed like a natural progression after spending some years studying the acute consequences of cerebrovascular disease in CKD. His group has a special interest in vascular cognitive impairment and dementia, which is particularly relevant to CKD patients given the clustering of vascular risk in this group. I feel very fortunate to have found such a caring and enthusiastic mentor to foster my cross-disciplinary interests! As part of this fellowship, I am also collaborating with Christopher Anderson at the Center for Genomic Medicine and Deborah Blacker at the Harvard T.H. Chan School of Public Health. This has been an incredible opportunity to learn more about genetic epidemiology as well as advanced causal inference methods from world experts.

STANLEY:
What are you excited to explore about this connection?

KELLY:
From polygenic risk scores to pairwise genome-wide association studies (GWAS) and Mendelian randomization analyses, I am excited—in awe really—of the evolving role that human genetic studies can play in elucidating causal relationships between kidney and brain diseases. Genetic epidemiology is a particularly powerful means of clarifying the temporality and directionality of these associations, and by leveraging the power of large GWAS, we may gain greater insights into biological mechanisms that identify novel targets for disease prevention.

STANLEY:
What’s something about the kidney-brain interaction that you find interesting that others might not fully appreciate?

KELLY:
For Nephrologists, Neurologists, and Intensivists, it is important to remember that dialysis is not always very brain-friendly! For example, the period of dialysis initiation is a high-risk time for patients with a particularly high incidence of stroke. The reasons for this excess risk are not entirely clear. It may relate to variable blood pressure and volume control as a similar surge of other blood pressure-related brain pathologies have been observed during this period including posterior reversible encephalopathy syndrome. In addition, during a dialysis session, cerebral blood flow has been shown to fall, and this has been associated with structural and functional brain changes. These changes correlate with cognitive testing scores after the dialysis session and also long-term cognitive changes. Preserving blood pressure and cooling the dialysate may be protective against this chronic hemodialysis-induced brain injury by achieving better hemodynamic stability and reducing circulatory stress. However, it is not known if regular use of cooled dialysate would impact incident stroke risk.

STANLEY:
Is there anything on your Boston Bucket-List of things you’d like to see or do?

KELLY:
In January 2022, I decided to join the MGH Marathon Team and run the Boston Marathon this April 18th in aid of the Pediatric Cancer Program at the MGH! I’ve been really blown away by my inspiring and hard-working colleagues at MGH as well as by the kindness and generosity of the people of Boston. I wanted to give something back to this incredible community that has welcomed me so graciously so hence, my participation in the quintessential Boston Marathon! Coming from Ireland though, training in snow and ice has certainly been a new experience for me! I will never complain about the rainy runs in Dublin again!

For more about Dr. Dearbhla Kelly, please follow her @DearbhlaKelly4 or visit her profiles:
https://www.ndcn.ox.ac.uk/team/dearbhla-kelly

https://www.gbhi.org/profiles/dearbhla-kelly

To support her marathon fundraising efforts please look here : https://www.givengain.com/ap/dearbhla-kelly-raising-funds-for-massachusetts-general-hospital/