Research programme

From kidney injury to kidney health — mechanism, monitoring, and multicentre trials.

My work in medical research began at the intersection of endocrinology and anaesthesia — optimising the perioperative treatment of patients with diabetes mellitus, improving glycaemic control and perioperative management to improve outcomes for these high-risk patients. That line has continued since my PhD, alongside old and new collaborations. A second focus, on postoperative organ injury and in particular the renoprotective effects of GLP-1 and SGLT2 inhibition, has since grown into its own line on kidney injury: it asks one question from three angles, can we predict, detect, and prevent acute kidney injury (AKI) during major surgery and critical illness — with the long-term goal of following patients far enough to stop a short-term injury becoming chronic kidney disease (CKD).

Bram Hulst hauling a mooring line across Arctic pack ice in front of the expedition ship Plancius
The research lineYou don’t follow a research line. You haul it.
Research line
Past and future directions

Studying the interplay of anaesthesiology, endocrinology and metabolism to reduce cardiovascular and renal complications after surgery. Upon completing medical school at KU Leuven, I began training in anaesthesiology at Amsterdam UMC, combining it with PhD research on the treatment of diabetes and perioperative glucose control. After my PhD, I continued this line of research together with my supervisors and colleagues at the department of endocrinology. Alongside this, I started developing my own independent research line, investigating the renoprotective effects of glycaemic control therapies. This grew into a research programme on the prediction, early detection, and prevention of acute kidney injury, with the long-term goal of reducing chronic kidney disease and improving overall outcomes for patients undergoing surgery.

Two research lines

Diagnosis, prevention & treatment of perioperative acute kidney injury

Earlier recognition of patients with, or at risk of, acute kidney injury (AKI), and interventions to prevent or treat it. AKI carries short-term harm — longer ICU and hospital stays, the need for renal replacement therapy, added morbidity and mortality — and, longer-term, progression toward chronic kidney disease and eventually transplantation or dialysis. Reducing its incidence or severity improves outcomes for patients and populations, and reduces healthcare costs.

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Perioperative glucose control & the treatment of diabetes mellitus

Glucose-lowering therapies and the optimal treatment of patients with diabetes mellitus in the perioperative period. Diabetes is one of the most common chronic conditions in the general population — it raises both the likelihood of needing surgery and the perioperative risk of complications. These high-risk patients are cared for daily by every physician working perioperatively in the Netherlands.

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Collaborating centres

Amsterdam UMC UMC Utrecht LUMC UMCG Amphia Ziekenhuis Medisch Spectrum Twente OLVG Medisch Centrum Leeuwarden Isala Catharina Ziekenhuis Royal Melbourne Hospital Royal Adelaide Hospital Florey Institute (University of Melbourne) Erasmus University KU Leuven Giessen University Hospital UZ Leuven ZOL Genk

Funding

The research programme is supported by the following grants and fellowships. Amounts, dates and reference numbers are added as they’re confirmed.

Marie Skłodowska-Curie Individual Fellowship

Amount€277,260 (EU contribution)
ForEfficacy of Leveraging Endocrine Therapies for Renoprotection during Intensive Care
WorkprogrammeMarie Skłodowska-Curie Actions – Global Fellowship, Horizon 2020
Awarded2021
Period36 months (18 outgoing + 6 secondment + 12 incoming)
ReferenceNo. 101024833

NWO Talent Programme

Amount€71,032 (€68,532 to host institute + €2,500 travel)
ForPostdoctoral fellowship at Royal Melbourne Hospital: “Nephroprotection through Incretin Therapy during Intensive Care” (NEPHRITIC)
WorkprogrammeNWO Talent Programme (Rubicon), administered by ZonMw
Awarded2020
Period12 months, to start no later than 15 Mar 2021
Reference452020104 (appl. 40-45200-98-20104)
Amount€320,000 (maximum)
ForNEPTUNE: metabolomics-driven biomarker discovery, ovine model and clinical trial for perioperative kidney protection
WorkprogrammeNWO Talent Programme (Veni)
Awarded2025
PeriodUp to 36 months, to start within 6 months of award
Reference09150162410006
Ministry of Health, Welfare and Sport logoZonMw’s Goed Gebruik Geneesmiddelen programme is commissioned by the Dutch Ministry of Health, Welfare and Sport (VWS)

Goed Gebruik Geneesmiddelen programme

Amount€974,972 (maximum)
ForCluster-randomised trial to improve adherence to perioperative glucose management protocols (~1,002 participants, 18 wards)
WorkprogrammeZonMw Goed Gebruik Geneesmiddelen (GGG), 12th call
Awarded2023
PeriodUp to 48 months (maximum)
Reference10140022210033
Amount€659,260 (maximum)
ForMulticentre RCT of SGLT2 inhibition (dapagliflozin) for renoprotection in cardiac surgery (target 784 participants, 7 centres)
WorkprogrammeZonMw Goed Gebruik Geneesmiddelen (GGG)
Awarded2021
PeriodUp to 36 months (maximum)
ReferenceProject 10140022010003
Amount€1,047,317 (maximum)
ForMulticentre RCT of continuing vs discontinuing SGLT2 inhibitors through cardiac surgery in patients already treated with one (target 652 participants, 7 centres, NL & Belgium)
WorkprogrammeZonMw Goed Gebruik Geneesmiddelen (GGG), Open Ronde 15 — grant title “SIRIUS”
Awarded2026
PeriodUp to 39 months (maximum)
ReferenceProject 10141022510066

Investigator Initiated Study programme

Amount€225,000
ForGLP-1 for bridging of hyperglycaemia during cardiac surgery
WorkprogrammeNovo Nordisk Investigator Initiated Study (IIS) programme
Awarded2016
PeriodJune 2017 – 2020 (planned 3-year enrolment, per protocol)

Patient organisations

Research Career

The Florey Institute
of Neuroscience and Mental Health
 
Melbourne, Australia

Postdoctoral Research Fellow

2020 – 2022

Graduate School
University of Amsterdam
 
Amsterdam, the Netherlands

PhD Candidate

2014 – 2021       Dissertation

UvA

Publications

Funding