Dr Haresh Selvaskandan

Dr. Selvaskandan is a clinical research fellow and a higher specialist nephrology trainee with an interest in glomerular diseases, medical technology and artificial intelligence in kidney disease. His research with the Mayer IgA nephropathy laboratories utilises methods including digital spatial profiling, laser capture micro-dissection, fluorescence-activated cell sorting and RNA-seq. Dr. Selvaskandan also has interests in applying artificial intelligence and machine learning methods to solve problems in clinical nephrology, and is developing skillsets in bioinformatics, python and R. Dr. Selvaskandan has secured over £700,000 in competitive funding for research, and has published widely in his fields of interest. 

Dr. Selvaskandan supports a variety of clinical trials for kidney disease with Leicester's Renal Clinical Research Team, was chair of the College of Life Science's Fellows Forum, is an executive committee member of the UK Kidney Association's Renal SpR Club, and is on the executive board of the UK Kidney MedTech Network.

Role of monocytes and glomerular endothelial cells in the formation of endocapillary hypercellularity in IgA Nephropathy.
Kidney Research UK, Kidney Care Appeal & NIHR Bioresource funded, Primary Investigator 

IgA nephropathy (IgAN) is the most common cause of primary kidney disease in the world. It affects young adults, 20-40% of whom progress to total kidney failure within 20-30 years of diagnosis. New treatments for the condition are needed, and studying a lesion in the kidney called endocapillary hypercellularity (E1) may provide an avenue for this. E1 consists of inflammatory cells (called macrophages, which are likely to develop from cells known as monocytes in the blood) within the blood vessels of the filtration system of the kidney (glomerular endothelial cells). E1 seems to be reversible with treatments that suppress the body's immune system. However, we know that suppressing the immune system to treat IgAN can carry serious risks. 

This funded project will delineate which genes are switched on and off in the monocytes and glomerular endothelial cells of those with IgAN who have E1 and those that don't. This will be achieved using techniques including digital spatial profiling, laser capture micro-dissection, fluorescence activated cell sorting and RNA sequencing. Differences between the two groups, and cell-cell interactions will be modelled and explored using bioinformatic tools built on R based platforms. Findings will be validated using dynamic in vitro models, to determine if any dysregulated pathways can be interrupted for therapeutic benefit. 

Developing and evaluating an artificial intelligence powered tool to support patients with IgA Nephropathy.
Kidney Research UK funded, Primary Investigator 

Being slowly progressive IgA Nephropathy is managed through out- patient clinic visits; diagnosis and management plans are discussed in 10-15 minute appointments that occur 2 – 4 times a year. Patients are inevitably left with questions between consultations, but reliable sources of information can be challenging to identify; a google search for “IgA nephropathy” yields over 290,000,000 results. A successful alternative to this has been patient support groups, where patients support each other with personal experience and knowledge. However, specialist knowledge may not be available, the forums may not be accessible due to language barriers, and some feel uncomfortable discussing their health in relatively open communities. This project is looking to develop and evaluate an artificial intelligence powered tool to support patients with a diagnosis of IgA Nephropathy.

Evaluating the role of lectin pathway activation in flares of IgA Nephropathy
Industry Funded  (Omeros), Primary Investigator 

Pain over the kidneys can be a common symptom in IgA nephropathy, but very little is understood about it. A study performed in Leicester, funded by Kidney Research UK, examined over 20,000 postings on social media and confirmed pain as a symptom widely experienced by those with IgAN. The incidence of IgAN peaks among young adults, and it is therefore likely this symptom confers significant psychosocial and socioeconomic impacts at both an individual and a societal level.

Artificial Intelligence and Acute Kidney Injury
NHS Digital Funded, Primary Investigator 

Acute kidney injury (AKI) refers to an abrupt disruption of kidney function, and complicates 13-18% of all hospital admissions in the UK. The cost associated with managing AKI is accordingly significant, estimated as being between £434 and £620 million every year. AKI can occur for many reasons including dehydration, low blood pressure, infections, and commencing medications that maybe toxic to the kidneys. For this reason, most AKIs in hospital occur in settings outside of specialist kidney units, and may not always be managed appropriately. In keeping with this, the mortality associated with AKIs are exceptionally high at 25-30%.  
 
This project will explore if artificial intelligence can be used to predict which patients will develop the most severe forms of AKI.

Book Chapters:

1. IgA Nephropathy & Henöch-Schonlein purpura.
Selvaskandan H, Cheung CK, Barratt J. Practical Nephrology, Springer. (2019)

2. Chronic Kidney Disease, Proteinuria & Haematuria
Selvaskandan H, Hull K, Barratt J. Best of Five MCQs for the ESE(Neph), Oxford Press. (2023)

3. IgA Nephropathy 
Selvaskandan H and Barratt J. Glomerular Diseases, GlomCon. (In press, 2023)

Reviews:

4. Novel Paradigms: Treatment of IgA Nephropathy
Selvaskandan H, Barratt J, Cheung CK. Kidney International Reports. 2023 (In Press)

5. Pathophysiology of IgA Nephropathy
Roberts L, Williams C, Oni L, Barratt J, Selvaskandan H. Indian Journal of Immunology. 2023 (In Press)

6. IgA Nephropathy: an overview of drug treatments in clinical trials.
Selvaskandan H, Gonzalez-Martin G, Barratt J, Cheung CK. Expert Opinion in Investigational Drugs. 2023 Dec;31(12):1321-1338

7. Clinical application of microRNAs in glomerular diseases
Selvaskandan H, Pawluczyk I, Barratt J. Nephrology Dialysis and Transplant. 2022 May;38(6):1375-1384

8. Immunological drivers of IgA nephropathy: exploring the mucosa-kidney link
Selvaskandan H, Cheung CK, Barratt J Journal of Immunogenetics. 2022 Feb;49(1):8-21

9. New insights into the pathogenesis and treatment strategies in IgA nephropathy 
Scionti K, Molyneux K, Selvaskandan H, Barratt J, Cheung CK Glomerular Diseases. 2022 Jan;2:15-29

10. Managing Crescentic IgA Nephropathy
Selvaskandan H. ASN Kidney News. 2021 Dec;13(12);20-21

11. The non-coding RNA landscape in IgA nephropathy – where are we in 2021?
Pawluczyk I, Selvaskandan H, Barratt J. Journal of Clinical Medicine. 2021 May;27:13(5):e15270

12. Monitoring immune responses in IgA Nephropathy: biomarkers to guide management
Selvaskandan H, Shi S, Twaij S, Cheung CK, Barratt J. Frontiers in Immunology. 2020 Oct;11:572754

13. New Strategies and Perspectives in Treating IgA Nephropathy 
Selvaskandan H, Cheung CK, Muto M, Barratt J. Clin Exp Nephrol. 2019 May;23(5):577-588.

14. IgA Nephropathy: Driving innovation with a rare renal disease registry. 
Selvaskandan H, Dillon M, Barratt J. Journal of Kidney Care. 2017 Jul; 2(4):205-211

15. MicroRNAs: A new avenue to understand, investigate and treat IgA Nephropathy?
Selvaskandan H  and Pawluczyk I, Barratt J. Clinical Kidney Journal. 2018 Feb;11(1):29-37

Original Research:

16. Risk factors associated with COVID-19 severity among patients on maintenance haemodialysis: a retrospective multi-centre cross-sectional study. 
Selvaskandan H, Hull KL, Adenwalla SF, Ahmed S, Cusu MC, Graham-Brown M, Gray L, Hall M, Hamer R, Kanbar A, Kanji H, Lambie M, Lee HS, Mahdi K, Major RW, Medcalf JF, Natarajan S, Oseya B, Stringer S, Tabinor M, Burton JO. BMJ Open. 2022 May 30;12(5):e054869 

17. Regional variations in nephrology trainee confidence with clinical skills may relate to the availability of local training opportunities in the UK: results from a national survey.  
Selvaskandan H, Baharani J, Hamer R. Clinical and Experimental Nephrology. 2022 Sep;26(9):886-897 

18. Burnout and Long COVID among the UK nephrology workforce: results from a national survey investigating the impact of COVID-19 on working lives. 
Selvaskandan H, Nimmo A, Savino M, Afuwape S, Brand S, Graham-Brown M, Medcalf J, Cockwell P, Beckwith H. Clinical Kidney Journal. 2022 Mar;15(3):517-526

19. A pilot study to predict risk of IgA nephropathy progression based on miR-204 expression. 
Pawluczyk I, Nicholson M, Barbour S, Er L, Selvaskandan H, Bhachu JS, Barratt J. Kidney International Reports. 2021 Jun 5;6(8):2179-2188.

20. An ethnic variation in the acceptance of biologic disease modifying therapies: a university hospital experience.  
Selvaskandan H, Moorthy A. Cureus. 2021; May;13(5): e15270. doi:10.7759/cureus.15270

21. Seroprevalance of antibody to S1 spike protein following vaccination against COVID-19 in patients receiving haemodialysis: a call to arms.
Billany RE, Selvaskandan H, Adenwalla SF, Hull KL, March DS, Burton JO, Bishop NC, Carr EJ, Beale R, Tang JW, Bird PW, Holmes CW, Baines R, Brunskill NH, Graham-Brown MPM Kidney International. 2021; Jun;99(6):1492-1494.

22. Macrophage interactions with collecting duct epithelial cells are capable of driving tubulointerstitial inflammation and fibrosis in IgA Nephropathy.
Pawluczyk I, Soares M, Barratt W, Brown J, Bhachu J, Selvaskandan H, Zeng Y, Sarania R, Molyneux K, Roberts I, Barratt J. Nephrology Dialysis Transplantation. 2020 Nov;35(11):1865-1877

23. Acoustic Trauma slows AMPAR-mediated EPSCs in the auditory brainstem reducing GluA4 subunit expression as a mechanism to rescue binaural function. 
Pilati N, Linley D, Selvaskandan H, Uchitel O, Hennig M, Kopp-Scheinpflug C, Ian D. Forsythe. Journal of Physiology. 2016 Jul; 594(13):3683-703. PMID: 27104476

Case Reports:

24. Acute respiratory distress syndrome driven by severe hypercalcaemia and acute kidney injury: a case report and literature review of a rare, life threatening complication
Selvaskandan H, Hull K, Gregory R, Pan D, Macriyiannis T, Briggs J, Richards C, Mason C, Jesus-Silva J, Bell R. Clin Nephrol Case Stud. 2022 Jan;10:21-27

25. Inhibition of the lectin pathway of the complement system as a novel approach in the management of IgA vasculitis associated nephritis.
Selvaskandan H, Cheung CK, Dormer J, Martinez M, Xu G, Barratt J. Nephron. 2020:144(9);453-458

26. Diabetic Myonecrosis in End Stage Renal Disease.
Selvaskandan H, Amablawaner K, Westacott R. Clin Nephol Case Stud. 2019 Jul 12;7:41-45

27. High dose oral linezolid achieved rapid clinical and microbiological recovery in a severely overweight male with long standing infected ulcers
Selvaskandan H, Denton-Beaumont R, Hamilton R. J Antimicrob chemother. 2019 Jun 1;74(6): 1755-1757.

28. Microangiopathic haemolytic anaemia in a young female. 
Selvaskandan H, Karavadra M, Paramasperan K, Glasby M, Iyasere O. Kidney Int. 2019 May;95(5): 1277-1278.

Letters:

29. Impact of the COVID-19 pandemic on training, morale and well-being amongst the UK renal workforce.
Beckwith H, Nimmo A, Savino M, Selvaskandan H, Graham-Brown MPM, Medcalf J, Cockwell P. Kidney International Reports. Mar 2021; 15;6(5):1433-1436.

30. The Exclusion of patients with chronic kidney disease in prospectively registered interventional trials for COVID-19. A Rapid review of international registry data,
Major RW, Selvaskandan H, Makkeyah Y, Hull KL, Kurverji A, Graham-Brown MPM. Journal of the American Society of Nephrology. 2020. Sep:ASN.2020060877 (online ahead of print)

31. View from here: Prescribing Skills Assessment. 
Selvaskandan H, Baheerathan A. Clinical Teacher. 2014 Feb;11(1):58-9. PMID: 24470836

32. View from here: Smart Phones & Medical Education. 
Baheerathan A, Selvaskandan H. Clinical Teacher. 2014 Oct;11(6):485-6. PMID: 25212943

33. The importance of counseling in young, female epileptic patients. 
Baheerathan A, Selvaskandan H. J of Paediatr Neurosci. 2013 Sep;8(3):265. PMID: 24470836

Published abstracts:

34. Digital Spatial Profiling can be used to study glomerular endothelial cells in IgA Nephropathy 
Selvaskandan H, Boys C, Pawluczyk I, Barratt J. Nephrology Dialysis and Transplantation 2023 June;38(1) 

35. WCN23-0066 Identifying druggable pathways in IgA Nephropathy using spatial transcriptomics
Selvaskandan H, Pawluczyk I, Barratt J. Kidney International Reports 2023 March;8(3):S49-50

36. WCN23-0139 Leveraging modern machine learning tools to predict outcomes of in-patient acute kidney injury
Selvaskandan H, Gauntley T, Heath D, Linfoot S, Xu G. Kidney International Reports. 2023 Mar;8(3):S98

37. Can artificial intelligence predict the need for acute renal replacement therapy among in-patients with acute kidney injury
Selvaskandan H, Gauntley T, Heath D, Linfoot S, Xu G. Future Healthcare Journal. 2023 10.7861/fhj.10-2-S1

38. Macrophage derived products induce pro-inflammatory and pro fibrotic responses in renal collecting ducts: A potential role in the pathogenesis of IgA nephropathy?
Pawluczyk I, Selvaskandan H, Zeng Y, Sarania R, Barratt J. Kidney Diseases. 2018 Sep;4(3):126

39. Is there an ethnic variation in the acceptance of biologic therapy among with axial spondyloarthropathies? 
Selvaskandan H, Moorthy A. Rheumatology. 2018 Apr; 57:key075.307

40. Ethnic Variation in the acceptance of biologic therapy among rheumatology patients - a university hospital experience. 
Selvaskandan H, Al-Ani H, Moorthy A. Annals of the Rheumatic Diseases. 2017 Jun; 76:1436

Affiliated publications:

41. Efficacy and safety of Sparsentan versus irbesartan in patients with IgA Nephropathy (PROTECT): 2-year results from a randomised active controlled phase 3 trial 
PROTECT Investigators. Lancet. 2023 Nov epub ahead of print.

42. Empagliflozin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative. Lancet Diabetes and Endocrinology. 2023 Dec. ePub ahead of print.

43. Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative. Lancet 2023 May 6;401(10387):1499-1507.

44. Sparsentan in patients with IgA Nephropathy: a pre-specified interim analysis from a randomised, double-blind, active-controlled clinical trial
PROTECT Investigators. Lancet. 2023 May 13;401(10388):1584-1594

45. IgA Nephropathy patient baseline characteristics in the Sparsentan PROTECT study.
PROTECT Investigators. Kidney International Reports. 2023 May

46. Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative. Lancet 2022 Jul 30;400(10349):359-368

47. Omicron neutralising antibodies after COVID-19 vaccination in haemodialysis patients.
Haemodialysis COVID-19 consortium. Lancet. 2022 Feb 26; 399(10327):800-802

48. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative Group. Lancet. 2022 Feb 12;399(10325):665-676

49. Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative Group. Lancet. 2022 Jan 8;399(10320):143-151

50. Neutralising antibodies after COVID-19 vaccination in UK haemodialysis patients. 
Haemodialysis COVID-19 consortium. Lancet. 2021 Aug; S0140-6736(21)01854-7

51. Convalescent plasma in patients with in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative Group. Lancet. 2021 May; S0140-6736(21)00897-7

52. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative Group. Lancet. 2021 May;397(10285):1637-1645

53. Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
RECOVERY Collaborative Group. Lancet. 2021 Feb 13;397(10274):605-612

54. Effect of Hydroxychloroquine in hospitalised patients with COVID-19 
RECOVERY Collaborative Group. New England Journal of Medicine. 2020 Nov;383(21):2030-2040.

55. Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. 
RECOVERY Collaborative Group. Lancet. 2020 Oct;396(10259): 

56. Dexamethasone in hospitalised patients with COVID-19: preliminary report
RECOVERY Collaborative Group. New England Journal of Medicine. 2020 July; doi: 10.1056/NEJMoa2021436 

Dr. Selvaskandan is currently supervising:

A post-doctoral researcher investigating the impact of loin pain in IgA Nephropathy 

An specialised foundation programme doctor applying digital spatial profiling methods to investigate the transcriptome of podocytes associated with minimal change disease

An intercalating masters student applying digital spatial profiling to investigate pathways of fibrosis active in IgA Nephropathy 

Two medical students who are working through datasets to identify biopsy related risk factors for IgA Nephropathy progression

Current:

Renal Precision Medicine Module Tutor
Clinical Sciences Bachelor of Sciences Course

SSRR Module Tutor
Intercalated Masters of Science Course

GlomCon Workshop Faculty
The Glomerular Disease Study & Trial Consortium (GlomCon)

Nephrology Educational Seminars Co-ordinator, John Walls Renal Unit 
John Walls Renal Unit, University Hospitals of Leicester NHS Trust

Previous 

Arterial Blood Gas Interpretation  
Developer of an interactive website (http://bit.ly/abg_12)

Acute Medical Care Simulation Facilitator 
University Hospitals of Leicester NHS Trust

Leicester Medical School Module Tutor
Leicester Medical School, University of Leicester 

Leicester Medical School Examinations Standard Setting Committee  
Leicester Medical School, University of Leicester

Chronic Kidney Disease - Mineral Bone Disease Management, Content Developer 
AMGEN sponsored educational seminar

East Midlands Core Medical Trainee Conference Organiser 
Health Education East Midlands

ELITE Medical Education Finals Course, Tutor  
ELITE medical education

Foundation Year Tutorial Scheme, Founder
Kettering General Hospital

Neurology Pre-clinical Teaching, Programme Lead 
Peer Led Teaching Initiative

Driving discoveries 2023: Prize winners

Ann Wyn Sherman Research Award

AI tool in development to detect serious kidney illness

Developing AI tools to recognise serious kidney illness

This is how you get spatial

Sri Lankan student Haresh Selvaskandan will carry Olympic Torch

Haresh Selvaskandan carries Olympic torch

Leicester students and alumni selected to carry Olympic torch

Up went the torch, so did the cheers

Future World Leader delegate from Sri Lanka carries Olympic Torch

Sri Lankan future world leaders 

2023 Kidney Research UK Driving Discoveries: Best Oral Presentation 
Kidney Research UK

2023 Cardiovascular Sciences Symposium: Best Poster
University of Leicester

2023 Glomerular Diseases Theme: Best Poster
UK Kidney Week

2023 Doctoral College Symposium: Best Presentation 
University of Leicester

2020 Endocrinology Society Prize
East Midlands Endocrinology Society

2017 David Ives Prize (1st Runner up)
University Hospitals of Leicester NHS Trust

2017 Midlands Rheumatology Society Presentation Prize (1st Runner up)
Midlands Rheumatology Society

2013 Frank Harris Prize
Leicester Medical School

2012 Peer Assisted Learning Award
University of Leicester

In Progress                         Doctor of Philosophy (In Progress)

                                                University of Leicester

2020                                       European Speciality Exam in Nephrology, ESENeph

                                                ERA-EDTA, UK Renal Association, Royal College of Physicians (UK)

2019                                       Masters of Research Methods (Distinction), MRes

                                                University of Leicester

2016                                       Membership to the Royal College of Physicians (UK), MRCP(UK)

                                                Royal College of Physicians

2013                                       Bachelor of Medicine, Bachelor of Surgery (Honours), MBChB(Hons)

                                                University of Leicester

2011                                       Bachelor of Sciences (First Class, Honours), BSc(Hons)

                                                University of Leicester

2015                                       Post-graduate Certificate in Medical Leadership (Distinction), PgCert

                                                Swansea University

2014                                       Post-graduate Certificate in Medical Education (Merit), PgCert

                                                Cardiff University