QUALIFICATIONS: MBBS, MD; DCH; DM (NEPHROLOGY); MRCPCH (UK); FRACP
Unconditional Unrestricted General and Specialist Registration – AHPRA AUSTRALIA (AHPRA: MED 0001549510)
SKILLS & ABILITIES
Renal Physician with interest in Adult and Paeditric Nephrology including Dialysis and Transplantation; Transitional Care in Nephrology
Leadership and Policy Development
Clinical Research, Teaching, Education and Evidence Based clinical Care
• Co –Clinical Lead, Renal Health Network, Health Networks Branch, Dept of Health, WA 2012 – till date
• Clinical Head – Armadale Renal Services – Armadale Health Services WA June 2004 – till date
• Renal Physician – Royal Perth Hospital and Health Services (Post reconfiguration of Health Services): Feb 2015 – till date
• Renal Physician – Fremantle Hospital and Health Services June 2004 – Jan 2015 (Until reconfiguration of Health Services)
• Renal Physician – St John of God Helath Care (Murdoch); Peel Health Campus (Mandurah) June 2004 – till date
• June 2013: Kidney Health Australia: OPERATION ANGEL Award: For Inspirational Contribution to the patients with Kidney Care in Western Australia
• 2012- 2013: ANZSN-Amgen Quality Assurance Grant ($ 10,000) for assessment of the development of Vascular access centre in Outer Metropolitan Hospital
• 2007: ANZSN- NEPHROLOGY RESEARCH GRANT ($ 35,000) for clinical research in Iron Overload in Haemodialysis population
• 1997: First Rank in University of Mumbai for DM (Nephrology) examinations
• Dec 1994: Pfizer Postgraduate Medical Award & Medallion & Scroll of honour for securing highest marks in Medicine in MBBS
• 1990-1991: N F Surveyor Gold Medal for 1ts Rank in MBBS at Grant Medical College, University of Mumbai
• March 1991: Prof M B Gharpure Memorial Prize (1st in Pharmacology) at Grant Medical College, University of Mumbai
• Merit awards and Scholarships by Govt of India and Maharashtra: HSC certification
2003: FRACP: Royal Australasian College of Physicians
2002: AMC: Australasian Medical Council Examinations
1999: MRCPCH (UK): Royal College of Physicians, United Kingdom
1997: DM (NEPHROLOGY): Doctor of Medicine, University of Mumbai, India
1995: MD (PEDIATRICS): Doctor of Medicine, University of Mumbai, India
1994: DCH: College of Physicians and Surgeons, Mumbai, India
1992: MBBS : Grant Medical College, University of Mumbai, India
2003 – 2004: Hon. Assistant Lecturer, Department of Paediatrics, Monash UNIVERSITY. MELBOURNE VIC.
DEC 1998 – DEC 1999: Clinical Lecturer in Paediatric Nephro-Urology; Guy’s and St. Thomas’s Hospital, and Kings College (University of London)
PRIOR WORK EXPERIENCE
Dec 2013 – Jan 2014: Hon. Transplant Fellow: Royal Prince Alfred Hospital, SYDNEY (inclusive of Westmead Hospital for Children and Westmead Adult Hospital)
April – June 2004: Consultant Locum Physician and Nephrologist; Latrobe Regional Hospital, PRINCESS Highway, Traralgon VIC
Feb 2003 – MARCH 2004: Senior Registrar Nephrology (Feb- April 2004); Clinical Fellow – Paediatric Nephrology (Feb 03- Feb 04), Monash Medical Centre, Melbourne VIC. Hon. Assistant Lecturer, Department of Paediatrics, Monash UNIVERSITY; AND Visiting Paediatrician, Latrobe Regional Hospital, Traralgon.
Jan 2002 – Jan 2003: Sr Registrar Paediatrics & Specialties (Community), Ballarat Base Hospital, VIC AND Princess Margaret Hospital for Children, Perth. WA
Jan 2000 – Jan 2002: Senior Registrar in Nephrology, Dialysis and Transplantation, Royal Perth Hospital, Perth. WA
Dec 1998 – Nov 1999: Hon. Specialist Registrar and Clinical Lecturer in Paediatric Nephro-Urology; Guy’s and St. Thomas’s Hospital, and Kings College (University of London)
Jan 1998 – Dec 1998: Sr Reg Paediatric Nephrology, Women’s & Children’s Hospital, Adelaide SA.
June 1995 – Dec 1997: Senior Registrar in Nephrology, Dialysis and Transplantation; Bombay Hospital Institute of Medical Sciences, Mumbai; Consultant Renal Physician (Aug – Dec 97); Kidney & Blood Pressure Clinic, Cooperage, Mumbai, INDIA
1992 – 1995: RMO, Sr RMO, Registrar & Senior Registrar in Paediatrics & Specialities; BJ Wadia Hospital for children AND Seth G S Medical College, University of Mumbai, India.
1986 – 1992: MBBS: Grant Medical College, University of Mumbai.
Royal Australasian College of Physicians
Australian and New Zealand Society of Nephrology
Australian and New Zealand Society of Pediatric Nephrology
Indian Society of Nephrology and Indian Society of Organ Transplantation (Life Member)
Vifor Pharmaceuticals – Product Iron carboxymaltose (2013-2014)
Novartis Pharmaceuticals – Product Afinitor for Tuberous Sclerosis (2014)
THESIS SUBMISSION FOR MD (1995 AND 1997)
– Low Molecular weight heparins in HD (1995-97): Thesis submitted to University of Mumbai. 1997
– Neonatal Skin lesions: Prospective Study (1992 – 1995): Thesis submission to University of Mumbai. 1995
Leadership Course (8.5 days): By Institute of Leadership; Dept. of Health (2014)
GCP for Research
Teaching on the Run: Facilitators Course (July 2012)
RACP: Supervisors Course
Risk Management Workshop – Mastering Work/Life Balance (May 2011)
Microsoft Excel : Intermediate (2011)
Teaching on the Run: Facilitator Course (2012)
ORGANISATION OF COURSES/ STUDY DAY
National Clinician Network Forum: Renal Division: Facilitator of the forum workshop (April 2014)
Ultrasound Course: A satellite course to ANZSN Annual Meeting. Australian and New Zealand Society of Interventional Nephrology. Sept 2010
Bone Mineral Study Day: Renal Nurse Practitioners – Western Australia: 19th June 2010
PROJECTS CURRENT AND THOSE INVOLVED IN THE LAST 5 YEARS
JULY 2012 Developed / updated CPAC Guidelines for Nephrology (July 2012) http://www.gp.health.wa.gov.au/cpac/speciality/docs/CPAC%20Renal%20Summary%20101125.pdf
Clinical Priority Access Criteria (CPAC) refers to an outpatient categorisation system that allows the prioritising of clinical conditions. CPAC assist GPs to assess relative patient need and in doing so, ensure that patients who require treatment more urgently are seen first by the Outpatient Clinic.
CPAC guidelines are used to select and prioritise patients for outpatient services in Western Australian hospitals.
The objective of CPAC is to provide more comprehensive information with each new GP referral to hospital specialists and therefore achieve the following: Reduce inappropriate referrals; commence specialist assessment and treatment more quickly; involve the GP in the patient’s hospital care; Reduce duplication of investigations and Reduce waiting time for outpatient based on clinical priority.
NATIONAL SURVEILLANCE NETWORK FOR CHRONIC KIDNEY DISEASE (CKD)
2014 We are involved in a collaboration of programs that are already collecting CKD data in Australia in order to develop regional profiles of CKD and its outcomes in various settings within Australia. Several partners have collaborated in grant applications to NHMRC and BUPA. The transformed meta-data will underpin regional maps of CKD and support informed predictions and interventions, well before information flows from more harmonised electronic approaches.
Partners in this project are: W Hoy, HG Healy, D Waugh, M Jose, I Katz, S Pirabhahar, R Walker, C Nelson, K Panaretto, A Salisbury and T Mathew. Towards a national surveillance network for chronic Kidney disease (CKD). (2013-2014)
CLINICAL STANDARDS PATHWAY – SMHS & RENAL HEALTH NETWORK COLLABORATION (Project closed by SMHS – 2015)
(RENAL) Lead facilitator for State-wide Policies (collaboration with NMHS and WACHS): http://www.healthnetworks.health.wa.gov.au/network/renal.cfm
• Hepatitis B Vaccination in Advanced CKD
• Parathyroidectomy in Advanced CKD
• Parenteral IV Iron therapy on HD and advanced CKD (In draft)
• Dialysis Access (PD and HD) (In draft)
Contributor in other CPS: • Removal Non-tunnelled Haemodialysis Catheter; Central Venous Catheter: Anticoagulation Lock
KPI PROJECT: INITIATIVE OF RENAL HEALTH NETWORK AND NATIONAL FORUM (2014)
The Renal Health Network (RHN) and its Executive Advisory Group (EAG) led by Co-Clinical Leads have developed a set of Quality Improvement (QI) Indicators for Renal Replacement Therapy (RRT) for state-wide use.
Health Networks are working with CMO office as a Data Custodian, with individual units contributing data at intervals.
This initiative is being collaborated with Renal Networks of other states to develop the Nationally agreed set of QUALITY IMPROVEMENT INDICATORS.
GP UPSKILLING INITIATIVE (2014) IN COLLABORATION WITH PRIMARY CARE NETWORKS
Advanced Renal Care in General Practice Service (ARC GPS) is supported by Renal and Primary Care Networks of Health Networks Branch to support GP up skilling in Renal Medicine. This aims to deliver improved clinical outcomes for renal patients in community, reduce hospital out-patient attendances and emergency admissions over time.
This Pilot project is planned as a 5 day rotation of Primary Care Physicians with clinical attachment to the Renal Unit – Sir Charles Gairdner Hospital with direct supervised exposure to CKD Clinics, Haemodialysis, Peritoneal Dialysis, Transplantation, Vascular access and inpatient care; and involvement in educational sessions.
The experience of this project over 12 months will be used for further expansion to SMHS after restructuring and reconfiguration.
TRANSITIONAL CARE FRAMEWORK (HEALTH NETWORKS INITIATIVE)
I have special interest in the TRANSITIONAL CARE as a qualified Paediatric and Adult Nephrologist.
2009: Transitional care – Model of Care: I was member of the working party and involved in the completion of Model of Care. The Transition Framework is developed by the Child and Youth Health Network WA. This Framework provides new focus on improving the transition of young people with chronic disease and disability from paediatric to adult care.
2014: Panel Member (NCN Forum) and Representative of Renal Health Network for National Clinicians Network Forum in April 2014.
ONGOING PROJECT (2014): RENAL DIALYSIS PLAN (2015-2025) BY RENAL HEALTH NETWORK
Renal Health Network has taken leadership in formulation of dialysis plan for WA for next decade (2015-2-25), with major changes to the functioning of dialysis services in conjunction with RDRG (Renal Dialysis Reference Group). This project includes:
• Study of existing services, shortfalls
• Projection of growth of dialysis numbers over the decade
• Study the prevalence of advanced CKD and study the progression according to SLR
• Study the effect of ABF and funding challenges
• Corporatisation of Home and Satellite Services: Modelling and Effects
• Assessment of the dependency of all existing patients on dialysis
• Assessment of carer needs and issues
• Make appropriate recommendations to provide patient centric services closer to their homes.
DEVELOPMENT OF POLICIES/ PROTOCOLS (OTHER THAN CPS- SMHS DOCUMENTS SUMMARISED ABOVE) Armadale Hospital and Health Services:
• Member of the MEDICAL SUBSPECIALITY COMMITTEE: Actively developed and participated in formation, modification, writing new policies for the hospital as well as Renal Unit.
Multiple policies and protocols are developed since 2004 with patient centric care (On Intranet) and include:
Nurse Practitioner related Protocols / projects:
• Bone Mineral Disease management; Hepatitis B Vaccination Protocol; Anticoagulation Protocol, and others
• Prophylaxis and Anticoagulation prior to Dental Procedures in Dialysis population
Fremantle Hospital Protocols (SELECTED RECENT Policies):
• Peritoneal Dialysis Related Peritonitis (Initial Treatment) Algorithm
• Peritoneal Dialysis Related Peritonitis (Subsequent Management) Algorithm
• Parathyroidectomy in CKD (2009)
• Multiple departmental policies and protocols
• IV Iron infusions (Iron Polymaltose, Iron Dextran and Iron Carboxymaltose): 2013
RENAL PALLIATIVE CARE PATHWAY: MODEL OF CARE (JULY-2012)
This Model of Care describes a care pathway for the establishment of an integrated patient-centric multi-disciplinary renal palliative care service. The service has a strong linkage with the palliative care team and primary care practitioners, with active involvement of the patient and carers in decision making. The service encompasses patient and family education, symptom management protocols, advance care planning, Liverpool Care Pathway for the last days and hours of life, and bereavement support.
This document is ratified by State Health Executive Forum in July 2012; with strong support for the initiative.
RENAL PALLIATIVE CARE PATHWAY IMPLEMENTATION PLAN (2012-2014) Implementation of the proposed pathway is continuing at 2 sites: 1 tertiary centre (Fremantle Hospital) and 1 Satellite Unit (Armadale Hospital) within existing resources. Ethics application to WA Aboriginal Ethics Committee and WA Health Ethics is continuing. A rural centre (Kalgoorlie) is also planned. These are continued within existing resources under my leadership.
VASCULAR ACCESS PATHWAY: HEALTH NETWORKS INITIATIVE
This project document explores the status of Vascular Access services within WA and makes recommendations to improve rates of native Vascular Access and avoidance of temporary lines. Key Performance Targets are suggested to access services, including the recommendation for need of development of Vein Preservation Policy. This document is awaiting SHEF tabling since Oct 2012.
SAFETY AND QUALITY: INVOLVEMENT IN VARIOUS HOSPITAL & STATE COMMITTEES
Medical Subspecialty Committee at Armadale Health Services
Drugs and Therapeutics Committee, Armadale Health Services
Mortality and Morbidity Meetings: Fremantle Hospital Renal Unit
WA Kidney Transplant Services: Meetings (Council and Members)
Root Cause Analysis involvement at SMHS wide
Renal Dialysis Reference Group
Clinical Review Committee: WA Home Dialysis Programme
Renal Management Meetings (Armadale and Fremantle Hospital)
Interdepartmental meetings: Histopathology; Journal Clubs, Grand Rounds and others
CRC (CLINICAL REVIEW COMMITTEE) OF WAHDIP:
MEMBER As an active member of WAHDIP – CRC, multiple issues related to Safety and Quality are addressed, including the increased rates of infections, and steps to address and review the effects.
New policies and procedures are developed, introduced and implemented.
I was instrumental in the designing of electronic database suitable for effective clinical use (MMEX) for the clinicians. This database is used since last 5 years.
As a representation from Fremantle Hospital, monthly visits for reviews are performed since 2012; with improved communication, patient care, and outcomes.
GRANT APPLICATIONS: Associate Investigator in: NHMRC Application for Feb 2014: APP1079502 Chronic Kidney Disease Centre of Research Excellence
Australia’s first CRE in chronic kidney disease (CKD) will be established through an established registry and surveillance collaboration. This will develop profiles of CKD patients in various primary care and renal practice settings, in several states, and in Indigenous and non-indigenous people; and follow the courses of those patients, and their outpatient trajectories, management, hospitalisations, outcomes, and costs.
Biomarker research is also conducted to define predictors of progression and cardiovascular events, which will influence CKD management pathways, and will aim to establish Australia’s first CKD Bio Bank. Health economic evaluations will be incorporated into all research streams, to define current costs, predict future costs, and test alternative models aimed at improving efficiency in CKD care and containing RRT.
CRE outputs should result in improved detection of CKD, slowed progression of the disease process, fewer cardiovascular deaths, better care pathways, and deceleration in rising rates of RRT, with more rationalised resource utilisation.
EXAMINER FOR FELLOWSHIP EXAMINATION FOR ROYAL AUSTRALASIAN COLLGE OF PHYSICIANS : 2012, 2013, 2014, 2015, 2016
PUBLICATIONS AND PRESENTATIONS
ABSTRACT SUBMISSIONS IN NATIONAL /INTERNATIONAL CONFERENCES
R Holman, S Mukhedkar, R Sinniah H. KULKARNI. Sunitinib induced acute interstitial nephritis-a case report. Nephrology 21, 259-259
Joseph B, Light C, KULKARNI H. Validation of escalation criteria and adult dialysis observation and response chart in dialysis unit. NEPHROLOGY 21, 182-182
C Light, H KULKARNI. Booster Hepatitis B Vaccination in haemodialysis patients – 5 year prospective study. NEPHROLOGY 20, 26-26
H KULKARNI, C Light. Cholecalciferol (Vit D) Therapy for low serum Vit D levels (LSVDL) in haemodialysis (HD) over 52 months -A prospective observational study. NEPHROLOGY 20, 67-67.
Light C, KULKARNI H. Safety and Efficacy of 200 mg IV Iron Polymaltose as push bolus in hemodialysis population: A Pilot Study ANZSN 2014
Graves A, Lisweski D, Adris N, Ferrari P, KULKARNI H. IV Calcium infusions (IV-Ca) following surgical parathyroidectomy (sPTX) in advanced chronic kidney disease (CKD): A centre experience NEPHROLOGY 19, 21-21, 2014.
W Hoy, HG Healy, D Waugh, M Jose, H KULKARNI, I Katz, S Pirabhahar, R Walker, C Nelson, K Panaretto, A Salisbury and T Mathew. Towards a national surveillance network for chronic Kidney disease (CKD). ANZSN 2014
D Wallooppillai, S Ognenis, P Ferrari, H KULKARNI. ¬Clinico-pathological effects in Renal Transplant recipients with mammalian target of Rapamycin inhibitors – A Centre Audit. ANZSN 2014
Ryan Jo, KULKARNI H, Ferrari P: Serum Gentamycin levels are not warranted with Gentamicin– Citrate Locks for Hickman Catheters: Audit. ANZSN- Brisbane 2013.
Graves A, Texler M, Manning L, KULKARNI H: Malakoplakia in a renal transplant recipient: Successful management outcome: Case report. ANZSN- Brisbane 2013.
Light C, Phikoo A, KULKARNI H. Aggressive Phosphate Lowering Project (OPAL) at Satellite Dialysis Unit (MDT team involvement). ANZSN- Brisbane 2013.
Graves A, KULKARNI H. mTORi associated cerebral venous sinus thrombosis: A Case Report. ANZSN- Brisbane 2013.
Light C, Kulkarni H. Cholecalciferol thearpy in 25OH Vit D Haemodialysis population: A Pilot Study. ANZSN 2011.
Chong S, Kulkarni H. Membranous GN with distal renal tubular acidosis- a Case Report. ANZSN 2011.
Kulkarni H, Ferrari P, Betti S, Olynyk J: Serum Iron markers do not predict changes in Liver Iron Content upon High dose parenteral iron in predialysis CKD patients: ANZSN 2010
ANZSN/ ASN 2009:
Kulkarni H, Ferrari P, Olynyk J: Hyperferritinemia correlated to iron overload in haemodialysis population: ANZSN 2009.
George Chin, R Holman, H Kulkarni. “Sweets Syndrome in a renal transplant recipient taking Azathioprine and Leflunomide: A case report”. Am Soc Neph, Annual Confer, 2009.
Kulkarni H, Olynyk J, Harrison C, Ferrari P. Magnetic Resonance Imaging demonstrates iron overload in patients on long term haemodialysis. Oral and Poster Presentation: ANZSN, 2008
Wright S, Kulkarni H, Yeap B, Ferrari P. Thyroid function after radioiodinated contrast in haemodialysis population. Poster Presentation for ANZSN 2008.
Abraham A, Singer R, Kulkarni H. Relapse of Nephrotic Range Proteinuria following conversion to mTOR therapy with Recurrence of Membranous GN in allograft: Am Soc of Nephrology Annual Meeting, San Francisco 2007:
Kulkarni H, Ferrari P. 1 year data on intradermal Hepatitis B vaccination protocol on patients with Stage 4 and 5 Chronic Kidney Disease. ANZSN Annual Conference: Melbourne. Sept 2006.
Kulkarni H, Warr K. Traumatic “Snapping” of Hickman catheters: 4 Case Reviews. ANZSN Annual Conference: Sydney. Sept 2005
Kulkarni H et al: Case report: Hypoglycemia during IV and oral Ganciclovir treatment in a renal transplant recipient. ANZSN Annual Conference: Adelaide Sept 2004
Kulkarni H, Henning P, Jureidini K. Cystatin C in term and Preterm infants over first 3 months of age. World Congress of Nephrology, Berlin (2003)
Kulkarni H, Hennig P, Vigneswaran R, Jureidini F. Cystatin C in term and Preterm infants over first 3 months of age. ANZSN, SEPT 2002.
Kulkarni H, Bethelham K, Martin A, Goldwater P. O group E. coli serology and its clinical correlation in the patients with HUS epidemic in S. Australia in 1995. Second European Congress on Enterhemorrhagic E. coli, Brussels, Acta Clinica Belgica; 54-1, p 37; 1999.
Kulkarni H, Jureidini F. Improvement with Kindergen PROD in Chronic renal failure in Children. 9th International Congress on Nutrition and Renal Disease
Kulkarni H, Kirpalani A (et al): Ann Cong, Int Society of Nephrology, SYDNEY,.
* Neoral as an acceptable alternative for Sandimmune.
* Post renal transplant acidosis.
* Hepatitis B & C in the renal transplantation.
Kirpalani AL, Ameen A,, KULKARNI H, Oza UG, Phadke AG. Hyperlactatemia in recipients immediately following renal transplant surgery. Proceedings of 9th Annual Conference of Ind Soc of Organ Transplantation (Jan 1997): Page 85.
Bichu SD, Kirpalani AL, Iyer VK, KULKARNI H, Oza UG. Is Hepatitis c INFECTION worse than Hepatitis B in renal transplant recipients? Proceedings of 9th Annual Conference of Ind Soc of Organ Transplantation (Jan 1997): Page 96.
KULKARNI H, Kirpalani A. Comparison of polysulphone and cuprophane dialysers in CAVHD’s. At Bombay Hospital Research Society Meeting, June 1996.
Nocardiosis in the renal transplant recipients – A center experience. At Bombay Nephrology Meet, July 1996.
OTHER PRESENTATIONS AND INVITED SPEAKER
1. Progress towards Renal Palliative Care Pathway. End of Life Workshop, Organised by CMO- DoH and Palliative Care Network (April 2014)
2. Transitional Care in Nephrology: National Clinicians Network Forum, Perth (April 2014)
3. National Perspectives of Indigenous Renal Transplantation. WAKTS Workshop/ Seminar. 14th March 2014.
4. Key Performance Indicators in WA Renal: National Renal Networks Lead Meeting, Organised by Kidney Health Australia, Melbourne (Feb 2014)
5. National CKD Surveillance Initiative: Role of WA. National meeting organised by Kidney Health Australia (Feb 2014)
6. Parathyroidectomy in CKD population: Rationale. Annual Meeting; Society of Endocrine Surgeons (27 July 2013)
7. Renal Involvement in Tuberous Sclerosis: Australasian Tuberous Sclerosis Society (2013)
8. Role of Health Networks in Western Australia: Roles and Activities: Nurse Leaders Meeting of Renal Nurse Leaders WA (2013)
9. Developments in Medicine and its impact: Indian Medical Association: Malad– Kandivali Branch (Dec 2012)
10. Management of PD related Peritonitis. PD Training Day for Advanced Trainees. 18th May 2012
11. Preservation of Peritoneal Membrane: Pathophysiology. PD Nursing Study Day, Organised by WAHDIP and Fresenius Med Care. 26th April 2012
12. Hypertension and Management, Polypharmacy in CKD. Grand Round, Royal Australasian College of General Practitioners, Perth. 31st August 2011
13. Iron overload in CKD. Roche Nephrology Transplant Symposium September 2011:
14. Approach to patients with CKD. Medical Nursing Study Day, St John of God HC, Murdoch, 1 June 2011
15. Safety of High dose IV Iron infusion IN Stage 3-5 CKD AND (Lack of) Correlation of Serum Iron Parameters and Hepatic Iron content in Haemodialysis population. 33rd Annual Scientific Meeting of Physicians, Friday 19th November 2010
16. Bone Mineral Study Day: Renal Nurse Practitioners – Western Australia: 19th June 2010
17. Management of Vesico-Ureteric Reflux: Paediatric Nephrology Association of India: 2006
MANUSCRIPT REVIEWS AND REVIEW NEPHROLOGY ADVANCED TRAINEE PROJECTS – RACP:
1. Pulmonary Embolism Associated with Endovascular Thrombolysis for Arteriovenous Fistula Thrombosis. RACP – Dec 2016
2. Patients Commencing Peritoneal Dialysis following a failed renal transplant have accelerated decline in residual renal function compared ti de-novo PD patients. RACP – Nov 2016
3. Psychosocial evolution of living organ donors: an international professional survey. RACP – Oct 2016
4. High Incidence of arterial and venous thrombosis in ANCA-associated vasculitis (AAV) – RACP – Oct 2016
5. Renal units with Vascular Access Nurses in Australia and New Zealand do not have higher rates of patients starting haemodialysis and arteriovenous fistula or graft. –RACP – Oct 2016
6. Late Antibody Mediated Rejection in Renal Transplant: Retrospective review of outcomes and prognostic indicators – RACP – Sept 2016
7. Epidemiology of biopsy-proven glomerulonephritis in Queensland adults. RACP – Jun 2016.
8. A four-year single centre experience of BK nephropathy managed with a Cidofovir-based regimen. RACP – Jan 2016
9. Preconditioning Therapy in ABO-Incompatible Living Kidney Transplantation: A Systematic Review and Meta-Analysis. RACP – Oct 2015
10. Maintenance of Blood Ionized Calcium does not Prevent Negative Calcium Flux in Regional Citrate Haemodialysis. Blood Purification. 29th July 2013
11. Conversion to sirolimus therapy in kidney transplant recipients with new onset diabetes mellitus after transplantation. Jour of Clinical and Developmental Immunology. March 2013
12. Safety of a rapid infusion protocol of iron polymaltose. Fremantle Hospital and Health Services: FHHS Drug Bulletin, Volume 37 Number 3, 2013:
13. Angiotensin converting enzyme inhibitors and aortic arch obstructive malformations’ Indian Journal of Medical Sciences. Sept 2006
14. A case of Marfan’s Syndrome with Aminoaciduria. Indian Journal of Medical Sciences. Jan 2006
PUBLICATIONS: Public URL for Google scholar: http://scholar.google.com.au/citations?user=gRzjH2wAAAAJ
1. Holman, R, Olynyk, JK, Kulkarni, H, and Ferrari, P (2016), Characterisation of hepatic and cardiac iron deposition during standard treatment of anaemia in haemodialysis. Feb 2017 Nephrology, 2017, doi: 10.1111/nep.12735.
2. SD Roger, CA Gaillard, AH Bock, F Carrera…H Kulkarni (As Investigator Group)… et al. Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial. Nephrology Dialysis Transplantation, 2016 doi: 10.1093/ndt/gfw264
3. Hoy, W. E., H. G. Healy, D. Waugh, M. D. Jose, H. Kulkarni, I. Katz, C. Nelson, K. Panaretto, and R. Walker. “Towards a national surveillance network for chronic kidney disease (CKD).” In Nephrology, vol. 19, pp. 58-88. 2014.
4. AL Graves, M Texler, L Manning, H Kulkarni. Successful treatment of renal allograft and bladder malakoplakia with minimisation of immunosuppression and prolonged antibiotic therapy. Nephrology, Vol 19, Suppl 1, 18-21, April 2014.
5. H Kulkarni, N Lenzo, A McLean‐Tooke. Causality of rhabdomyolysis and combined tetanus, diphtheria and acellular pertussis (Tdap) vaccine administration. The Journal of Clinical Pharmacology 53 (10), 1099-1102, 2013
6. DW Johnson, FG Brown, M Clarke, N Boudville, TJ Elias, MWY Foo, B Jones, H Kulkarni.. Et al…The Effects of Biocompatible Compared with Standard Peritoneal Dialysis Solutions on Peritonitis Microbiology, Treatment, and Outcomes: the balANZ Trial. Peritoneal Dialysis International 32 (5), 497-506 ; 2012
7. DW Johnson, FG Brown, M Clarke, N Boudville, TJ Elias, MWY Foo, B Jones, H Kulkarni.. Et al…Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes: J Am Soc Nephrol 23, 1097-1107 , 2012
8. DW Johnson, FG Brown, M Clarke, N Boudville, TJ Elias, MWY Foo, B Jones, H Kulkarni.. Et al…The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial Nephrology Dialysis Transplantation. 2012
9. Ferrari P, Kulkarni H, Dheda S, Betti S, Harrison C, St. Pierre T, and Olynyk J. Serum Iron Markers Are Inadequate for Guiding Iron Repletion in Chronic Kidney Disease Clin J Am Soc Nephrol Jan 2011 (Published online on September 28, 2010 as doi:10.2215/CJN.04190510)
10. Clark BM, Boan P, Kulkarni H. A Case of Legionella longbeachae Pneumonia Complicated by Rhabdomyolysis and Acute Renal Failure Requiring Hemodialysis. Infectious Diseases in Clinical Practice. 18(6):413-416, November 2010.
11. JK Olynyk, P Ferrari, H Kulkarni, TC Tan, D Trinder. Non-invasive characterisation of significant hepatic iron overload in hyperferritinemic subjects. HEPATOLOGY, Vol 48, Issue 4, 1170A, 2008
12. Singer R, Rhodes H, Chin G, Kulkarni H, Ferrari P. High prevalence of ascorbate deficiency in an Australian peritoneal dialysis population. Nephrology (Carlton), 2008: Volume 13 Issue 1 Page 17-22.
13. Howman H, Kulkarni H. Antibody-mediated acquired Pure Red Cell Aplasia after treatment with darbepoetin – Nephrology Dialysis Transplantation 2007 22(5):1462-1464.
14. Thomas MA, Luxton G, Moody HR, Woodroffe AJ, Kulkarni H, Lim W, Christiansen FT, Opelz G. Subjective and quantitative assessment of patient fitness for cadaveric kidney transplantation: the “equity penalty”. Transplantation. 2003 Apr 15;75(7):1026-9.
15. H Kulkarni, K Jureidini, P Trnka, P Henning, R Vigneswaran, S Harris Cystatin C is a promising marker of renal function in newborns during first 3 months. Nephrology Dialysis Transplantation 18 (18 (suppl 4): 808-813.), 808-813 2003
16. Playford D, Kulkarni H, Thomas M, Vivian J, Low A, Mander J, Perlman D, Finch P.
17. Intra-ureteric capsaicin in loin pain haematuria syndrome: efficacy and complications. BJU Int. 2002 Oct;90(6):518-21.
18. Kulkarni H, Goldwater PN, Martin A, Bettelheim KA. Escherichia coli ‘O’ group serological responses and clinical correlations in epidemic HUS patients. Comp Immunol Microbiol Infect Dis. 2002 Jul;25(4):249-68.
19. H Kulkarni, S Bichu, U Oza, A Kirpalani. Sulphonamide crystalluria induced acute renal failure in a renal allograft. —A case report, Indian Journal of Nephrology, Vol 7, No 1, 20-21, Jan-Mar 1997.
20. Patnekar PN, Kulkarni HA, Khopkar SR, Kulkarni VS, Nerurkar RS
21. Nevus flammeus in tuberous sclerosis Indian Pediatr. 1995 Sep;32(9):1038-9.
22. H KULKARNI: Antiphospholipid Syndrome in a single kidney- A case report: Indian Journal of Renal Sciences, 1999.
23. H KULKARNI: Can Cystatin C replace creatinine as a marker of renal function? Review article in Indian Journal of Renal Sciences, 1999.
INVESTIGATOR INITIATED TRAILS/ AUDITS
1. Impact of Nurse Practitioner led management of Renal Anaemia in CKD population Screening for renal disease in asymptomatic normal population on World Kidney Day
2. Incidence of Vitamin D deficiency in Haemodialysis population AND Effect of intervention with Vit D in deficient haemodialysis population
3. Financial impact on reduction in Hb target in a Satellite Dialysis Unit
4. Effect of large dose IV iron in CKD population on the serum markers and liver iron content.
5. Correlation of hepatic iron content and serum markers for iron deficiency
6. Ferriscan in incident HD population as a marker for hepatic Iron overload
7. Cystatin C in Preterm infants as a marker of renal function
8. Prevalence of Vitamin C deficiency in Haemodialysis population
9. Intradermal Hepatitis B vaccination in Dialysis / CKD population
CURRENT RESEARCH 1. PI: Prospective observational study of correction of Vit D deficiency by cholecalciferol (2009- till date) – Armadale Dialysis Unit
2. PI: Study of progression and prevalence of CKD in population in WA (2003-2013) – Planned with RDRG, Epidemiology Branch and Data linkage of DoH
3. PI: Analysis of the outcomes of the Palliative Care pathway (Application in WA Ethics, already approved by WA Aboriginal Health Ethics)- 2014
4. PI: Outcomes of Renal Transplantation in ATSI population (Study with ANZDATA – In communication)- 2014
5. PI: Survey of Co-morbidity burden in patients on dialysis in Western Australia (2014 – as a part of Dialysis Plan 2015-2025)
6. PI: Survey of Carer needs in in patients on dialysis in Western Australia (2014 – as a part of Dialysis Plan 2015-2025)
CURRENT PROJECTS (PUBLISHED PROJECTS ARE EXCLUDED) 1. “Just do it”: Dietary Phosphate Control (NP initiated project at Armadale Dialysis Unit)
2. Prospective assessment of QoL, Comorbidity burden and Symptom burden in patients on HD (Project at Armadale Dialysis Unit)
3. Assessment of the development of Armadale Access Centre (2014) and its impact on the tertiary centre.
4. BSI (Blood stream Infections) and ANZDATA related analysis
NURSE PRACTITIONER RELATED PUBLICATIONS 1. Hepatitis B Vaccination in Late (Stage 4 and 5) Chronic Kidney Disease
http://www.nursing.health.wa.gov.au/docs/career/np/SMAHS/AKDH_HepatitisB_Vaccination.pdf Approved 16 Feb 2010
2. Warfarin Therapy in Haemodialysis Patients
http://www.nursing.health.wa.gov.au/docs/career/np/SMAHS/AKDH_Warfarin_Therapy.pdf Approved 23 April 2010
3. Management of Renal Anaemia in Stage 4/5 Chronic Kidney Disease (Version 2) http://www.nursing.health.wa.gov.au/docs/career/np/SMAHS/AKDH_Man_renal_anaemia.pdf Revised 2010. Approved 30th Jun 2010
4. Management of Hyperphosphatemia in Chronic Kidney Disease
http://www.nursing.health.wa.gov.au/docs/career/np/SMAHS/AKDH_Management_Hyperphosphataemia.pdf Approved 2007.
INDUSTRY SPONSORED CLINICAL RESEARCH (PRINCIPAL OR CO-INVESTIGATOR):
1. FER-CKD (VIFOR) 2010- 2011: An Open-label, Multicentre, Randomised, 3-arm Study to Investigate the Comparative Efficacy and Safety of Intravenous Ferric Carboxymaltose (Ferinject® High- and Low-dosage Regimens) versus Oral Iron for the Treatment of Iron Deficiency Anaemia in Subjects with Non-dialysis-dependent Chronic Kidney Disease.
2. PRIMS trial: A Prospective, Immunogenicity Surveillance (PRIMS) Registry to Determine the Incidence of Erythropoietin Antibody Mediated Pure Red Cell Aplasia (PRCA) Among Patients With Chronic Renal Failure and Subcutaneous Exposure to Recombinant Erythropoietin Products
3. BALANZ trial: Multi-centre, multi-country randomized controlled trial was to determine whether neutral pH, low GDP dialysate better preserves residual renal function in PD patients over a 2 year period compared with conventional dialysate
4. RESTORE trial: Removal Of Tacrolimus For Sirolimus Following Thymoglobulin Induction On The Development of Regulatory T Cells (RESTORE)
5. SPICE trial: 09/275 A study of the pharmacokinetics and safety of deferasirox (Exjade®) in haemodialysis dependent subjects with chronic kidney disease, with secondary iron overload from intravenous iron and erythropoietin therapy: The SPICE study
6. SHARP Trail: Co-Investigator This randomised double-blind trial included 9270 patients with chronic kidney disease (3023 on dialysis and 6247 not) with no known history of myocardial infarction or coronary revascularisation. Reduction of LDL cholesterol with simvastatin 20 mg plus ezetimibe 10 mg daily safely reduced the incidence of major atherosclerotic events in a wide range of patients with advanced chronic kidney disease.
7. EVOLVE Trial – Co-investigator RCT in dialysis: In an unadjusted intention-to-treat analysis, cinacalcet did not significantly reduce the risk of death or major cardiovascular events in patients with moderate-to-severe secondary hyperparathyroidism who were undergoing dialysis.
8. COLLABORATIVE TRIAL GROUP: Co-Investigator The Effect of Sulodexide in Overt Type 2 Diabetic proteinuria – Co-investigator