COIN Investigators
COIN Investigators
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Catherine "Kate" Butler, MD, MA
- Title: Core Investigator; K-23 Awardee
Assistant Professor, University of Washington School of Medicine - Contact: Catherine.Butler2@va.gov
- Location: Seattle
- University of Washington webpage
Research Interests
Dr. Butler is an Assistant Professor in the Division of Nephrology at the University of Washington and an HSR research fellow working under the primary mentorship of Dr. Ann O’Hare. Her research interests include healthcare intensity at the end-of-life for older adults with advanced kidney disease, opportunities to support person-centeredness and equity in the kidney transplant evaluation, and healthcare resource allocation during the COVID-19 pandemic. She received her BA from Tufts University, her MD from Washington University in St. Louis School of Medicine, and completed her internal medicine residency, research nephrology fellowship, and Masters’ degree in bioethics at the University of Washington. She is a recipient of the University of Washington Chair of Medicine Scholars Award.
See Dr. Butler's Dimensions profile that includes: publications, grants, datasets, patents and clinical trials
Recent Grants & Funding
Promoting an equitable and Veteran-centered approach to cardiac evaluation prior to kidney transplant
Coronary artery disease screening is a common component of the pre-transplant evaluation process for Veterans with kidney failure. Still, mounting evidence across the broader population suggests that the practice may not benefit asymptomatic patients and can involve risks and burdens. We propose two complementary research aims that build upon data already collected as part of an ongoing IIR-supported project (18-032, O’Hare):
1) Describe temporal trends in the frequency of coronary disease screening among Veterans engaged in the kidney transplant evaluation process;
2) Characterize clinical decision-making and care processes that shape these practices. Findings will build a foundation for future work to develop a more standardized, equitable, and Veteran-centered approach to cardiac evaluation before kidney transplant.
Funder: Seattle-Denver COIN HSR Small aWard Initiative For impacT (SWIFT) Grant
Strengthening Shared Decision-Making for Older Adults with Kidney Failure Considering Kidney Transplant
Role: PI
Kidney transplants can be a valuable treatment option for older adults with kidney failure. However, the required physical and psychosocial evaluation process can mean substantial burdens for older adults, and many will not ultimately receive a kidney.
To ensure that the approach to care during this evaluation process aligns with the values and goals of individual patients, we propose a research agenda that will strengthen shared decision-making for older adults considering referral for kidney transplant evaluation.
Together with an integrated career development plan, this work will also support Dr. Catherine Butler's transition to becoming an independent physician-scientist whose research focuses on making the kidney transplant evaluation process more person-centered and equitable.
Funder: National Institute of Diabetes and Digestive and Kidney Diseases
NIH website Publications of note:
— The Role of Dialysis Organizations in Promoting and Facilitating Access to Nondialytic Treatment Options
— Experiences of US Clinicians Contending With Health Care Resource Scarcity During the COVID-19 Pandemic, December 2020 to December 2021
— Differences Among Racial and Ethnic Minority Groups in the Unmet Existential and Supportive Care Needs of People Receiving Dialysis
Kidney Injury in Patients with Acute Decompensated Heart Failure: Ethics Supplement
Role: Co-I; PI: Nisha Bansal
Acute decompensated heart failure is a significant cause of hospitalization and poor clinical outcomes in the U.S. population. Kidney function is a crucial determinant of management and prognosis in acute decompensated heart failure patients. Still, current clinical measures of kidney function are inadequate for use in these patients.
The goal of this proposal is to identify novel kidney measures that may be used to guide therapy and determine prognosis in patients with acute decompensated heart failure.
Funder: National Institute of Diabetes and Digestive and Kidney Diseases
NIH website Publications of note:
— Change in cardiac biomarkers and risk of incident heart failure and atrial fibrillation in chronic kidney disease: the CRIC Study
Promoting the equity and effectiveness of home-based palliative care for patients with dialysis-dependent chronic kidney disease
Role: Collaborator
Funder: University of Pennsylvania Leonard Davis Institute of Health Economics CKD Initiative
Recent Publications
2024
Butler CR, Reese PP, Cheng XS. Referral and Beyond: Restructuring the Kidney Transplant Process to Support Greater Access in the United States. Am J Kidney Dis. 2024 Apr 24:S0272-6386(24)00743-1. doi: 10.1053/j.ajkd.2024.03.017. Epub ahead of print.
PMID: 38670253.
Johansen KL, Gilbertson DT, Li S, Li S, Liu J, Roetker NS, Ku E, Schulman IH, Greer RC, Chan K, Abbott KC, Butler CR, O'Hare AM, Powe NR, Reddy YNV, Snyder J, St Peter W, Taylor JS, Weinhandl ED, Wetmore JB. US Renal Data System 2023 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2024 Apr;83(4S1):A8-A13. doi: 10.1053/j.ajkd.2024.01.001.
PMID: 38519262.
Morenz A, Ng YH, Butler CR. Learning From the Experiences of Undocumented Immigrant Kidney Transplant Recipients-From Exceptional Individuals to Equitable Systems. JAMA Netw Open. 2024 Feb 5;7(2):e2354548. doi: 10.1001/jamanetworkopen.2023.54548.
PMID: 38421654
2023
Butler CR, Wightman AG, Taylor JS, Hick JL, O'Hare AM. Experiences of US Clinicians Contending With Health Care Resource Scarcity During the COVID-19 Pandemic, December 2020 to December 2021. JAMA Netw Open. 2023 Jun 1;6(6):e2318810. doi: 10.1001/jamanetworkopen.2023.18810. PMCID: PMC10276299.
PMID: 37326986
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Butler CR, Wightman AG. Beyond Autonomy: Ethics of Decision Making About Treatments for Kidney Failure at the Extremes of Age. Am J Kidney Dis. 2023 Apr 5:S0272-6386(23)00584-X. doi: 10.1053/j.ajkd.2023.01.451. Epub ahead of print.
PMID: 37028637
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Wong SPY, Prince DK, Kurella Tamura M, Hall YN, Butler CR, Engelberg RA, Vig EK, Curtis JR, O'Hare AM. Value Placed on Comfort vs Life Prolongation Among Patients Treated With Maintenance Dialysis. JAMA Intern Med. 2023 Mar 27. doi: 10.1001/jamainternmed.2023.0265. Epub ahead of print.
PMID: 36972031
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Kattah AG, Butler CR. The nephrologist's role in supporting people with chronic kidney disease and unplanned pregnancy post-Dobbs. J Am Soc Nephrol. 2023 Jan 17. doi: 10.1681/ASN.0000000000000081. Epub ahead of print.
PMID: 36749205
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2022
O'Hare AM, Vig EK, Iwashyna TJ, Fox A, Taylor JS, Viglianti EM, Butler CR, Vranas KC, Helfand M, Tuepker A, Nugent SM, Winchell KA, Laundry RJ, Bowling CB, Hynes DM, Maciejewski ML, Bohnert ASB, Locke ER, Boyko EJ, Ioannou GN; VA COVID Observational Research Collaboratory (CORC). Complexity and Challenges of the Clinical Diagnosis and Management of Long COVID. JAMA Netw Open. 2022 Nov 1;5(11):e2240332. doi: 10.1001/jamanetworkopen.2022.40332.
PMID: 36326761
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Butler CR. Understanding Public Perspectives on Opt-Out Deceased Donor Transplant Policy: Ethically Obligatory and Practically Necessary. Clin J Am Soc Nephrol. 2022 Oct 26:CJN.11230922. doi: 10.2215/CJN.11230922. Epub ahead of print.
PMID: 36288932
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Butler CR, Wachterman MW, O'Hare AM. Concurrent Hospice and Dialysis: Proof of Concept. J Am Soc Nephrol. 2022 Sep 12:ASN.2022080919. doi: 10.1681/ASN.2022080919. Epub ahead of print.
PMID: 36096635
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Struthers SA, Kribs Z, Butler CR. Policy and Kidney Community Engagement to Advance toward Greener Kidney Care. J Am Soc Nephrol. 2022 Aug 18:ASN.2022070741. doi: 10.1681/ASN.2022070741. Epub ahead of print. PMID: 35981765.
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Watnick S, Butler CR. Difelikefalin: A Novel Therapy for Dialysis Patient Care. Kidney Med. 2022 Jul 7;4(8):100519. doi: 10.1016/j.xkme.2022.100519. PMCID: PMC9386091. PMID: 35991692.
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Butler CR, Sharma RK, Eneanya ND, Bernacki GM, Ghuman JK, Curtis JR, O'Hare AM. Differences Among Racial and Ethnic Minority Groups in the Unmet Existential and Supportive Care Needs of People Receiving Dialysis. JAMA Intern Med. 2022 Jul 11. doi: 10.1001/jamainternmed.2022.1677. Epub ahead of print. PMID: 35816354.
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Butler CR, Webster LB, Diekema DS. Staffing crisis capacity: a different approach to healthcare resource allocation for a different type of scarce resource. J Med Ethics. 2022 Jul 1:medethics-2022-108262. doi: 10.1136/jme-2022-108262. Epub ahead of print. PMID: 35777960.
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Butler CR, Watnick S. The Role of Dialysis Organizations in Promoting and Facilitating Access to Nondialytic Treatment Options. Kidney Med. 2022 May 13;4(6):100480. doi: 10.1016/j.xkme.2022.100480. PMCID: PMC9142681. PMID: 35637926.
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Butler CR, O'Hare AM, Wong SPY. Supporting scholarship in palliative care across the medical specialties. J Pain Symptom Manage. 2022 Jun;63(6):e665-e666. doi: 10.1016/j.jpainsymman.2022.02.007. PMID: 35595386.
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O'Hare AM, Butler CR, Laundry RJ, Showalter W, Todd-Stenberg J, Green P, Hebert PL, Wang V, Taylor JS, Van Eijk M, Matthews KL, Crowley ST, Carey E. Implications of Cross-System Use Among US Veterans With Advanced Kidney Disease in the Era of the MISSION Act: A Qualitative Study of Health Care Records. JAMA Intern Med. 2022 May 16. doi: 10.1001/jamainternmed.2022.1379. Epub ahead of print. PMID: 35576068.
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Butler CR, Webster LB, Diekema DS, Gray MM, Sakata VL, Tonelli MR, Vranas KC. Perspectives of Triage Team Members Participating in Statewide Triage Simulations for Scarce Resource Allocation During the COVID-19 Pandemic in Washington State. JAMA Netw Open. 2022 Apr 1;5(4):e227639. doi: 10.1001/jamanetworkopen.2022.7639. PMID: 35435971.
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Gray MM, Butler CR, Webster LB, Tonelli MR, Sakata VL, Diekema DS. Patient Information Items Needed to Guide the Allocation of Scarce Life-Sustaining Resources: A Delphi Study of Multidisciplinary Experts. Disaster Med Public Health Prep. 2022 Feb 10:1-7. doi: 10.1017/dmp.2021.351. Epub ahead of print. PMID: 35139979.
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Butler CR. A Critical Role for Shared Decision-Making about Referral and Evaluation for Kidney Transplant. Kidney360. 2022 Jan 27;3(1):14-16. doi: 10.34067/KID.0007642021. PMCID: PMC8967623. PMID: 35368579.
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Butler CR, Webster LB, Sakata VL, Tonelli MR, Diekema DS, Gray MM. Functionality of Scarce Healthcare Resource Triage Teams During the COVID-19 Pandemic: A Multi-Institutional Simulation Study. Crit Care Explor. 2022 Jan 21;4(1):e0627. doi: 10.1097/CCE.0000000000000627. PMCID: PMC8785932. PMID: 35083438.
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2021
Butler CR, Appelbaum PS, Ascani H, Aulisio M, Campbell CE, de Boer IH, Dighe AL, Hall DE, Himmelfarb J, Knight R, Mehl K, Murugan R, Rosas SE, Sedor JR, O'Toole JF, Tuttle KR, Waikar SS, Freeman M; Kidney Precision Medicine Project. A Participant-Centered Approach to Understanding Risks and Benefits of Participation in Research Informed by the Kidney Precision Medicine Project. Am J Kidney Dis. 2021 Dec 4:S0272-6386(21)01008-8. doi: 10.1053/j.ajkd.2021.10.006. Epub ahead of print.
PMID: 34871700.
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Saeed F, Butler C, Clark C, O'Loughlin K, Engelberg R, Hebert P, Lavallee D, Vig E, Kurella Tamura M, Curtis JR, O'Hare A. Family Members' Understanding of the End-of-Life Wishes of People Undergoing Maintenance Dialysis. Clin J Am Soc Nephrol. 2021 Sep 10:CJN.04860421. doi: 10.2215/CJN.04860421. Epub ahead of print.
PMID: 34507967.
Butler CR, O'Hare AM, Kestenbaum BR, Sayre GG, Wong SPY. An Introduction to Qualitative Inquiry. J Am Soc Nephrol. 2021 Jun 1;32(6):1275-1278. doi: 10.1681/ASN.2021040473. Epub 2021 May 26.
PMID: 34039668.
Butler CR, Wong SPY, Vig EK, et al. Professional roles and relationships during the COVID-19 pandemic: a qualitative study among US clinicians. BMJ Open 2021;11:e047782.
doi:10.1136/bmjopen-2020-047782.
2020
Butler CR, Wightman A, Richards CA, Laundry RS, Taylor JS, Hebert PL, Liu CF, O'Hare AM. Thematic Analysis of the Health Records of a National Sample of US Veterans With Advanced Kidney Disease Evaluated for Transplant. JAMA Intern Med. 2020 Nov 23:e206388. doi: 10.1001/jamainternmed.2020.6388. Epub ahead of print. PMCID: PMC7684522.
PMID: 33226419.
Butler CR, Wong SPY, Wightman AG, O'Hare AM. US Clinicians' Experiences and Perspectives on Resource Limitation and Patient Care During the COVID-19 Pandemic. JAMA Netw Open. 2020 Nov 2;3(11):e2027315. doi: 10.1001/jamanetworkopen.2020.27315. PMCID: PMC7648254.
PMID: 33156349.
O'Hare AM, Butler CR, Taylor JS, Wong SPY, Vig EK, Laundry RS, Wachterman MW, Hebert PL, Liu CF, Rios-Burrows N, Richards CA. Thematic Analysis of Hospice Mentions in the Health Records of Veterans with Advanced Kidney Disease. J Am Soc Nephrol. 2020 Nov;31(11):2667-2677. doi: 10.1681/ASN.2020040473. Epub 2020 Aug 6. PMCID: PMC7608965.
PMID: 32764141.
Butler CR, Reese PP, Perkins JD, Hall YN, Curtis JR, Kurella Tamura M, O'Hare AM. End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005-2014. J Am Soc Nephrol. 2020 Oct;31(10):2424-2433. doi: 10.1681/ASN.2020030342. Epub 2020 Sep 9. PMCID: PMC7608994.
PMID: 32908000.
Butler CR, Taylor JS, Reese PP, O'Hare AM. Thematic analysis of the medical records of patients evaluated for kidney transplant who did not receive a kidney. BMC Nephrol. 2020 Jul 25;21(1):300. doi: 10.1186/s12882-020-01951-1. PMCID: PMC7382039.
PMID: 32711468.
2019
Butler CR, Vig EK, O'Hare AM, Liu CF, Hebert PL, Wong SPY. Ethical Concerns in the Care of Patients with Advanced Kidney Disease: a National Retrospective Study, 2000-2011. J Gen Intern Med. 2020 Apr;35(4):1035-1043. doi: 10.1007/s11606-019-05466-w. Epub 2019 Oct 25. PMCID: PMC7174459.
PMID: 31654358.
O'Hare AM, Murphy E, Butler CR, Richards CA. Achieving a person-centered approach to dialysis discontinuation: An historical perspective. Semin Dial. 2019 Sep;32(5):396-401. doi: 10.1111/sdi.12808. Epub 2019 Apr 10.
PMID: 30968459.
Butler CR, O'Hare AM. Complex Decision Making about Dialysis in Critically Ill Older Adults with AKI. Clin J Am Soc Nephrol. 2019 Apr 5;14(4):485-487. doi: 10.2215/CJN.01870219. Epub 2019 Mar 21. PMC6450338
PMID: 30898871.
