Todd Miano
University of Pennsylvania, PA·Medicine & Clinical Research
Patients who are very sick with infection often receive strong antibiotics. Some of these drugs, and some of the conditions they treat, can harm the kidneys or are hard to manage safely.
- Fields
Medicine & Clinical Research
Pharmacology
Public Health & Epidemiology
- Topics
acute kidney injury
nephrotoxicity
vancomycin
- Grants
- 2 known grants, through May 2030
What they work on
- Test whether kidney injury linked to vancomycin plus piperacillin-tazobactam is a pseudotoxicity, meaning creatinine rises without real tissue damage, in a randomized trial against vancomycin plus cefepime in acutely ill patients with infection.
- Use repeated measurements of a broad panel of kidney function and injury biomarkers, including cystatin C, to build a time-based molecular signature of vancomycin kidney toxicity.
- Test whether baseline plasma renin, a blood-pressure hormone, predicts whether fluid-liberal or vasopressor-based resuscitation reduces organ injury and death in sepsis-induced hypotension, using CLOVERS trial samples.
- Identify patterns of plasma renin over time in patients with sepsis-induced hypotension and test whether they predict mortality, then relate renin, prorenin and soluble (pro)renin receptor to markers of endothelial dysfunction.
More about the research
A key problem is that doctors track kidney health mainly with creatinine, a blood marker that responds slowly and can change for reasons unrelated to kidney damage. This research tests better blood markers in critically ill patients. The goals are to judge whether a widely used antibiotic pair truly harms the kidneys and to guide treatment of low blood pressure in sepsis.
Why it matters
Hospitals may be avoiding a useful antibiotic combination because of a kidney safety concern that could reflect a quirk of creatinine testing rather than real injury. A definitive trial and better kidney markers could help clinicians choose antibiotics safely and catch drug-related kidney injury earlier. Separately, renin testing could help doctors personalize fluid or vasopressor treatment for patients with sepsis-induced low blood pressure and better judge their risk of poor outcomes.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
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University of California-San Francisco, CA·Medicine & Clinical Research
Test whether norepinephrine, which constricts vessels and strengthens the heartbeat, prevents postoperative acute kidney injury better than phenylephrine, a pure vasoconstrictor, in adults undergoing major non-cardiac surgery under general anesthesia.
Nisha Bansal
University of Washington, WA·Medicine & Clinical Research
Test whether targeting home systolic blood pressure, rather than pre-dialysis blood pressure, below 140 mmHg reduces dangerous blood pressure drops during dialysis, in a 200-patient two-center crossover randomized trial of hemodialysis patients.
Denise Hasson
New York University, NY·Medicine & Clinical Research·Early-career
Characterize baseline nutritional status in 200 high-risk pediatric ICU patients using dietary questionnaires, malnutrition screening, arm circumference, skinfold thickness, grip strength and muscle ultrasound, and test whether these risk subtypes predict acute kidney injury.
The school
University of Pennsylvania: 90 labs on PI Pages, $2.2B a year on research, 750 research doctorates a year.
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