Dr. Branko Braam is Prof. Medicine and Adjunct Prof. Physiology, is currently the interim Division Director for nephrology (since Dec 2016). He also holds the Kidney Health Translational Research Chair of the Div. Nephrology/Dept. Medicine /Fac. Medicine and Dentistry.
After completing medical school at the Univ. Utrecht, The Netherlands, Dr. Branko Braam trained in Utrecht (Prof. Koomans) and at Tulane Univ., Dept. Physiology (Prof. Navar) in renal hemodynamics. After completing his Ph.D., he started residency in Internal Medicine, followed by Nephrology, both at the Univ. Med. Center Utrecht. From 2001-2006, he was staff nephrologist in Utrecht, and a Research Fellow of the Royal Academy for Arts and Sciences. In 2006 he moved to the Univ. of Alberta in Edmonton, where he since been Attending Staff in the Nephrology Division.
Dr. Braam practices general nephrology and has a special interest in Hypertension and Cardiovascular Disease related to kidney disease. His research interests are on systemic manifestations of kidney disease (vascular function, inflammation, and the heart kidney interface) as well as hypertension.
Hypertension, volume regulation and cardiovascular function in CKD, in hemodialysis patients and in patients with combined heart and renal failure (‘cardiorenal syndrome’) form the main clinical interests of Dr. Braam. He has published a book on volume regulation in hemodialysis, together with his former mentor, the late Prof. Evert Dorhout Mees, and the current director of the Northern Alberta Renal Program, Prof. Jindal. He also is first author on a recent publication on behalf of the Am. Soc. Nephrology Hypertension Advisory Group on resistant hypertension 2. Currently a QI project is being implemented to improve volume control in hemodialysis and CKD patients using bio-impedance technology.
- Hypertension and Cardiovascular Aspects of Dialysis Treatment - Clinical management of volume. Branko Braam, Kailash Jindal, Evert J. Dorhout Mees. 2nd Edition. 2011.
- Recognition and Management of Resistant Hypertension. Braam B, Taler SJ, Rahman M, Fillaus JA, Greco BA, Forman JP, Reisin E, Cohen DL, Saklayen MG, Hedayati SS. Clin J Am Soc Nephrol. 2016 Nov 28.
Renal hemodynamics and blood pressure regulation
Graduate training was in renal hemodynamics, the renin angiotensin system and nitric oxide (supervisors Prof. Koomans, Utrecht University, and Prof. Navar, Tulane Univ., New Orleans) using renal cortical micropuncture and microperfusion. A major breakthrough was my observation at Tulane Univ. that Ang II concentrations in the proximal tubular fluid are 100-1000 fold higher than in the plasma and that the proximal tubule secretes Ang II into the tubular lumen 1. In subsequent experiments, I designed, performed and reported that the local nitric oxide (NO) system was shown to balance local Ang II activity 2. Current work in this area is together with Dr. Cupples in Vancouver 3. In a CIHR funded project we are investigating coupling of nephrons in the regulation of renal blood flow using laser speckle imaging and microCT 4.
- Braam B, Mitchell KD, Fox J, Navar LG. Am J Physiol. 1993;264:F891-898. PMID 8388654.
- Braam B. Am J Physiol. 1999;276:R1551-1561. PMID 10362731.
- Cupples WA, Braam B. Am J Physiol Renal Physiol. 2007;292:F1105-1123, PMID 17229679.
- Mitrou N, ..., Braam B, …, Cupples WA. Am J Physiol Renal; 2015 ePub; PMID: 25587114.
Application of genomics to study systemic consequences of kidney and heart failure
In 1999, I set out a program in Utrecht apply microarrays to study the consequences of hypertension for cells and target organs. Supported by my ‘CAREER’ grant from the Dutch Kidney Foundation and my Academy Research Fellowship by the Royal Dutch Academy of Arts and Sciences, I set up a molecular lab to perform expression analysis using microarrays. I have performed studies at the cellular level 1, in animals (experimental hypertension, e.g. 2) and in humans. In humans, working together with my friend and colleague Dr. Carlo Gaillard, I have identified extensive modulation of gene expression in leukocytes of patients with hypertension (inflammation and blood pressure-related genes) 3. In follow-up, I currently investigate monocytes as sentinel cells for systemic disease 4.
- Braam B, de Roos R, Bluyssen H, et al. Hypertension. 2005;45:672-680. PMID 15699468.
- Chon H, …, Braam B. Eur J Pharmacol. 2005;513:21-33. PMID 15878706.
- Chon H, Gaillard CA, …, Braam B. Hypertension. 2004;43:947-951 PMID 15007037.
- Jie KE, …, Braam B. PLOS One 2012;7(9):e41339. PMID 22957013.
Heart and Kidney interactions: unraveling complexity of cardiorenal syndromes
A third closely related theme is concomitant heart and kidney failure, also referred as the (ill defined 1) cardiorenal syndrome. As an initial step we have proposed a theoretical model of ‘cardiorenal connectors’ as link between heart and kidney function (RAS, inflammation, NOS/ROS balance and SNS) 2. This has been widely recognized (176 citations on Web of Science). More recently, my focus has also returned to unresolved issues in systemic and local hemodynamics in heart and kidney failure 3. Currently, studies are aimed at elucidating the mechanisms by which renal venous pressure impairs renal function in heart failure (Heart and Stroke Foundation of Canada) and renal autoregulation in humans with heart failure measured with intrarenal flow probes (local funding). The HSFC project includes measurements of glomerular capillary pressure and tubuloglomerular feedback using in vivo micropuncture, as unique place in Canada where this technology is available.
- Braam B, …, Gaillard CA. Nat Rev Nephrol. 2014 Jan;10(1):48-55. PMID 24247284.
- Bongartz L, …, Braam B. Eur Heart J. 2005 Jan;26(1):11-7. PMID 15615794.
- Braam B, Cupples WA, Joles JA, Gaillard C. Heart failure reviews. 2012. PMID 21553212
Dr. Braam has been involved in Medical Informatics for many years. While still in The Netherlands, he developed a small Electronic Medical Record to support a hypertension clinic. In Canada, he has been Medical Lead for the Nephrology Information System (NIS) over the last 6 years. Currently, the NIS team is designing an electronic implementation of an Integrated Plan of Care for Nephrology.