The Harer Research Group is conducting translational research on kidney function in neonates who require hospitalization in the neonatal intensive care unit (NICU). Our long-term research goal is to more effectively diagnose acute kidney injury (AKI) in the NICU, allowing early interventions to prevent and treat AKI, ultimately leading to decreased rates of chronic kidney disease (CKD) in childhood and adulthood.
AKI occurs in 18-48% of preterm infants (dependent on the gestational age at birth), is difficult to diagnose, and has significant implications on neonatal and long-term health outcomes. It’s dangerous and costly – infants with AKI are more likely to die and have prolonged hospital stays. Not only does AKI result in short-term adverse outcomes, but multiple adult, pediatric, and now neonatal studies have shown that it significantly increases the risk of CKD following hospital discharge.
The Harer Research Group is working on ways to improve the diagnosis of AKI through two non-invasive measures: 1) near infrared spectroscopy (NIRS), a tool used to obtain continuous non-invasive measurements of kidney tissue oxygenation and 2) urinary metabolomic biomarkers.
Another area of interest to the research group is the use of methylxanthines, specifically caffeine, to prevent and treat AKI. In a secondary analysis of a multicenter trial published in JAMA Pediatrics (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2676168), Dr. Harer and colleauges found that caffeine prevents AKI in preterm neonates. Given this finding, the team aims to determine whether caffeine can be used to treat AKI, if detected early with non-invasive monitoring. Collaborative studies are under development to determine if methylxanthines (caffeine, theophylline) can be used in neonates with hypoxic ischemic encephalopathy undergoing therapeutic hypothermia to prevent AKI.
In addition to these projects, Dr. Harer also collaborates with other deparments and divisons within the UW to improve the health of newborn kidneys. Currently projects include: 1) Investigating the effect of indomethacin tocolysis in pregnant mothers and its effect on neonatal kidney function with the Division of Maternal Fetal Medicine and 2) Evaluating the use of NIRS to diagnose AKI in post-operative cardiac surgery neonates with the Divisions of Critical Care and Cardiothoracic Surgery.
Dr. Harer is actively involved with the international Neonatal Kidney Collaborative (NKC), a group established to improve the health of newborns at risk for kidney disease, serving as a member of the steering committee and co-chair of the communications committee. The landmark study, AWAKEN (Assessment of Worldwide Acute Kidney Injury) performed in 2013 resulted in over 10 publications on neonatal AKI. Future studies aim to determine the long-term outcomes of AKI in this population.
Finally, Dr. Harer founded the URINN (Uw Renal Investigative Neonatal Network) group dedicated to improving the kidney care of neonates at UW. This network includes Pediatric Urologists, Nephrologists, Infectious Disease physicians, and Neonatologists at the UW that collaborate to develop quality improvement projects on topics such as management of hydronephrosis, reducing the use of nephrotoxins, and treatment of urinary tract infections.
Matthew Harer, MD, assistant professor, Neonatology and Newborn Nursery, has been awarded a 2022 Travel Grant for Early Career Investigators by the International Pediatric Research Foundation and the journal Pediatric Research for his 2021 paper, “Renal tissue oxygenation …March 11, 2022
Matthew Harer, MD, assistant professor, Neonatology and Newborn Nursery, has mentored students in the Shapiro Research Program for the past three years. “I really enjoy the whole process,” reflected Harer. “It’s really awesome to see …July 7, 2021
Matthew Harer, MD, assistant professor, Neonatology and Newborn Nursery, was selected for the highly competitive UW Institute for Clinical and Translational Research (ICTR) KL2 Scholars Career Development Program. The KL2 program provides promising clinical and translational …June 3, 2021
A cohort of first-year medical students were matched with fourteen pediatric faculty mentors for the 2021 Shapiro Summer Research Program. The Shapiro Summer Research Program provides opportunities for medical students to participate in eight- to …May 26, 2021
Matthew Harer, MD, recently received a $149,960 Wisconsin Partnership Program (WPP) New Investigator Award for his project, “Non-invasive Diagnosis of Acute Kidney Injury in Premature Infants”. The goal of this two-year project is to develop …October 30, 2020
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