• Dionne, Janis


    Investigator, BC Children's Hospital
    Clinical Associate Professor, Division of Nephrology, Department of Pediatrics, University of British Columbia

    Degrees / Designations
    B.Sc., MD, FRCPC
    Primary Area of Research
    Evidence to Innovation
    Secondary Area(s) of Research
    Lab Phone
    Mailing Address

    BC Children's Hospital
    Room K4-148
    4480 Oak Street
    Vancouver, BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Chronic Kidney Disease in Childhood
    • Pediatric Hypertension

    Chronic kidney disease does not just affect adults but can occur during childhood as well. It is important to identify children with impaired kidney function early and manage the disease to prevent adverse outcomes including poor growth, malnutrition, high blood pressure, bone disease, and cardiovascular disease. Our goal is to monitor the children that have been identified as having chronic kidney disease over time to identify areas for improvement in their healthcare and quality of life.

    Management of high blood pressure is important to maintain good cardiovascular health. With 24 hour blood pressure monitoring we are gaining new insight into normal and abnormal blood pressure patterns and how this could adversely affect health. This non-invasive tool can be used in many groups of patients and currently we are studying blood pressure abnormalities in pediatric chronic kidney disease patients and pediatric long-term cancer survivors with many other future applications available.

    Current Projects

    With the assistance of a database manager, I have created a chronic kidney disease database for all pediatric patients followed at BC Children’s Hospital with a GFR of <75 ml/min/1.73m2. We will prospectively be entering their medical information into the database to create a source of data for quality assurance studies as well as research intervention studies.

    The major areas of focus of the database include renal disease progression, anemia management, renal bone disease, growth and nutrition, cardiovascular health, and morbidity and mortality. We hope to determine factors that contribute to the development or progression of abnormalities in the organ systems affected during renal failure.

    On a related topic, we are joining a study by Canadian nephrologists looking at the prediction of risk of progression to dialysis or cardiovascular events or death in the chronic kidney disease population. This is a three year observational study looking at biomarkers of vascular health, inflammation, cardiac function/health and kidney dysfunction in samples of blood and urine taken at routine renal clinic visits. Outcomes identified will include initiation of renal replacement therapy, time to cardiovascular events, onset of cardiac dysfunction and death. The goal is to identify biomarkers that can predict progression of kidney disease or predict cardiac events in order to monitor or intervene if patients are identified as high risk.

    24-hour ambulatory blood pressure monitoring (ABPM) has identified new ways to monitor and treat patients with hypertension. Blood pressure abnormalities that can be identified on ABPM include daytime and night-time hypertension, elevated blood pressure loads, and nocturnal blood pressure non-dipping. This non-invasive test is diagnostic for white-coat hypertension, masked hypertension, nocturnal hypertension or non-dipping, and autonomic dysfunction. Various blood pressure abnormalities are possible in patients that have received nephrotoxic medications or treatments. These patients are also at risk for permanent renal injury. Through a pediatric resident initiative, we have identified long-term survivors of childhood cancer as a group at risk for blood pressure and kidney abnormalities. In collaboration with the Oncology long-term follow-up clinic, we are going to review all patients at 5 years post-cancer diagnosis to determine if there are specific cancer diagnoses that have increased rates of clinic hypertension. Once these high-risk groups are identified, we will prospectively study blood pressure and renal function by simple methods including 24-hour ABPM, serum creatinine for estimated GFR, and urine microalbumin as a marker of renal damage. This study will determine the prevalence of renal injury and blood pressure abnormalities in long-term pediatric cancer survivors and the need for monitoring and treatment of identified issues to maintain good long-term health.

    Selected Publications
    Sinha R, Dionne J.  Ambulatory blood pressure monitoring in children.  Indian Pediatr 48:119-122, 2011.

    Dionne JM, Abitbol CL, Flynn JT.  Hypertension in infancy: Diagnosis, management and outcome.  Pediatr Nephrol 27:17-32, 2012.

    Dionne JM, Abitbol CL, Flynn JT.  Erratum to: Hypertension in infancy: Diagnosis, management and outcome.  Pediatr Nephrol 27:159-160, 2012.

    Dionne JM, Flynn JT. Hypertension in the neonate.  NeoReviews 13(7):e401-409, 2012.

    Dionne JM, Lou K, Er L, Collin K, White CT. Pharmaceutical cost distribution in childhood chronic kidney disease. Pediatr Nephrol 27:1531-1539, 2012.

    Ajarmeh S, Er L, Brin G, Djurdjev O, Dionne JM. The effect of a multidisciplinary care clinic on the outcomes in pediatric chronic kidney disease. Pediatr Nephrol 27:1921-1927, 2012.

    Textbook Chapter:

    Dionne JM. Neonatal and Infant Hypertension. In: Flynn J, Ingelfinger J, Portman R, editors. Pediatric Hypertension. 3rd ed. New York, NY. Springer; 2013:395-420. 

    Honours & Awards

    ASPN Trainee Basic Science Research Award, American Society of Pediatric Nephrology, 2005 The Fundamentals of Dialysis in Children: Case Conference Competition, Dialysis Annual Conference, 2005

    Honours in Research, Department of Medicine, University of Alberta. 2000

    Research Group Members