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Research

The pages below give an outline of the research being undertaken by the kidney units at Guys and St Thomas’ NHS Foundation Trust and King’s College Hospital Foundation Trust.


Translating research into improving health and well being

Research at King's College Hospital

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Studies are underway to improve the treatment of anaemia in kidney patients.

The kidney department at King's College Hospital is currently conducting over 30 clinical trials in kidney care and also undertaking laboratory based research into chronic kidney disease. There is a strong focus on anaemia associated with kidney disease, diabetic kidney disease, and progression of kidney failure.

 

Studies in the Kidney Clinic

  • Professor Iain Macdougall is internationally renowned in the field of renal anaemia and is head of the clinical research team.  He is the Chief Investigator of both the PIVOTAL study, funded by a grant of £3.4 million from Kidney Research UK, and also the PEDAL study, funded by a grant of £2.1 million from the NIHR. The PIVOTAL study is conducted across 50 sites in the UK, and has randomised 2141 patients to a high-dose IV iron regimen versus a low-dose IV iron regimen for the last 2 to 4 years. Results are expected in late-2018. The PEDAL study is ongoing, with a target recruitment of 380 patients, and is investigating the possible benefits of exercising during dialysis on a stationary bike. He is the chair of the steering committee of the NIHR-funded SIMPLIFIED study, and is on the steering committee of several other studies, including ASCEND, which is a programme of studies investigating a new orally-active agent for CKD anaemia, daprodustat (a HIF stabiliser). 
  • Dr Claire Sharpe is one of twelve investigators across the UK studying new ways to monitor kidney function. She is working on the eGFR-C study with Dr Edmund Lamb of East Kent Hospitals University NHS Foundation Trust, to determine the Accuracy of glomerular filtration rate (GFR) estimation using creatinine and cystatin C and albuminuria for monitoring disease progression in patients with stage 3 chronic kidney disease: prospective longitudinal study in a multi-ethnic population.
  • Dr Kate Bramham is conducting a study of pregnant women with chronic kidney disease, to explore mechanisms underlying poor pregnancy outcomes and biomarkers to diagnose progression of kidney disease during pregnancy.  She is also leading a multi-centre intervention study to explore the use of dietary nitrate (Beetroot juice) and sildenafil to protect kidney function in pregnancy, and an international study at five centres in UK, Sweden and Canada to develop a tool to predict the deterioration of kidney disease in pregnancy.  These studies are funded by Kidney Research UK.
  • Dr Kate Bramham is working with Dr Marlies Osterman (GSTT ITU Nephrologist) to validate the role of novel urinary biomarkers for prediction of acute kidney injury in women with hypertensive pregnancies, and is working with Dr Sam Hutchings (KCH ITU Consultant) to investigate the relationship between microcirculatory abnormalities and the development of acute kidney injury in patients with sepsis (MICROSHOCK study) and cardiac surgery (HEART-AKI).  She is also collaborating with the PRECISE network to develop point of care testing to detect early acute kidney injury for pregnant women in Kenya.
  • Dr Kate Bramham is leading a study at KCH, working with Dr Lara Roberts, to investigate new ways of predicting bleeding risk in patients with chronic kidney disease (COAG-KD 0 funded by Kidney Research UK). 

    To find out more please contact Dr Kate Bramham: kate.bramham@kcl.ac.uk

  • Dr Shah is the PI for OUTSMART: A randomized controlled clinical trial to determine if a combined screening  /treatment programme can prevent premature failure of renal transplants due to chronic rejection in patients with HLA antibodies. This study is in the follow-up phase.
  • Dr Shah is the PI for EMPIRIKAL: A Double Blind Randomized Controlled Investigation into the efficacy of Mirococept (APT070) for preventing ischaemia-reperfusion injury in the kidney allograft. The data from this study is currently being analysed.
  • Dr Shah is the PI for PRO2TECT: Phase 3, Randomized, Open-Label, Active Controlled Study Evaluating the Efficacy and Safety of Oral Vadadustat for the Maintenance Treatment of Anaemia in Subjects with Non-Dialysis Dependent Chronic Kidney Disease. 
  • Dr Sui Phin Kon is the principal Investigator at King’s for a study to investigate the efficacy and safety of finerenone in 2 studies: [1] on the progression of kidney disease in subjects with type 2 diabetes mellitus and the clinical diagnosis of diabetic kidney disease, in addition to standard of care; [2] on the reduction of cardiovascular morbidity and mortality in subjects with type 2 diabetes mellitus and the clinical diagnosis of diabetic kidney disease, in the addition to standard of care.
  • Dr Kon is also the principal Investigator of a study on the Effects of Atrasentan on Renal Outcomes in Subjects with Type 2 Diabetes and Nephropathy
  • She is also the principal Investigator of the Dialysis Outcomes and Practice Patterns study (DOPPS).  Information is collected on approximately 13,000 dialysis patients in 19 countries over a 3-year.  Dr Kon has been the PI for DOPPS 3, DOPPS 4, DOPPS 5 and DOPPS 6.
  • Dr Richard Hull has a specialist interest in autoimmune kidney disease and was the principal investigator at King’s for the RITUXILUP study in patients with SLE. This study investigated whether an antibody treatment called Rituximab is effective in treating lupus nephritis when given with MMF, but without oral steroids.
  • He is the principal investigator for the UK Vasculitis Registry at King’s.
  • He is also currently principal investigator for a number of studies investigating new treatments for IgA Nephropathy and primary FSGS alongside investigating the new class of drugs for treating kidney anaemia, called HIF stabilisers in collaboration with Professor Macdougall.
  • Dr Sharlene Greenwood was recently awarded a NIHR Clinical Lectureship fellowship to complete a bi-centre feasibility study evaluating the effect of exercise training on progression of kidney disease.
  • Dr Greenwood and Professor Macdougall were recently awarded a Kidney Research UK project grant to conduct an exploratory multicentre prospective double-blind randomised controlled trial of the effect of intravenous iron supplementation with or without exercise training in iron-deficient, but not anaemic, patients with chronic kidney disease on exercise capacity, physical function, fatigue and skeletal muscle metabolism.
  • Dr Greenwood was awarded a British Renal Society / Kidney Care UK grant to evaluate cultural influences on physical activity for patients with CKD.
  • Dr Greenwood is the PI for the BISTRO study – a multi-centre study to evaluate a possible clinically significant lengthening in time to anuria in those incident HD participants  randomised to a bioelectrical impedance intervention.
  • Dr Greenwood is primary supervisor for a KRUK AHP fellowship (awarded to Ellen Castle). This PhD will evaluate a novel online intervention to combat weight gain in new kidney transplant recipients.
  • Dr Helen MacLaughlin (Consultant Dietitian) recently completed her National Institute of Health Research (NIHR) Clinical Lectureship fellowship investigating the effect of body size on kidney function after acute kidney injury (Ob AKI feasibility study).  She is now collaborating with researchers in the United States to do further research on this topic. 
  • Dr MacLaughlin is also working with a team from King’s College London on research related to blood glucose control with nutritional support drinks in haemodialysis patients with diabetes (GRO-HD) and on novel weight loss interventions in obesity and chronic kidney disease (MIX-UP).
  • Dr Martin Ford is a principal investigator at King’s for the STOP-ACEi study on Angiotensin Converting Enzyme inhibitor (ACEi) / Angiotensin Receptor Blocker (ARB) withdrawal in advanced renal disease.
  • He is the principal investigator for the DIALIZE study to reduce the incidence of pre-dialysis hyperkalaemia with Sodium Zirconium Cyclosilicate.He is also the principal investigator for the VERIFIE study investigating the long term real life safety, effectiveness, and adherence of Velphoro® in patients with hyperphosphataemia undergoing haemodialysis or peritoneal dialysis
  • Dr Katie Vinen is PI for the PREPARE study.  This study acknowledges the uncertainty about whether dialysis extends life or improves symptoms in our older and frailer patients.  PREPARE is a randomised controlled trial comparing preparation for the dialysis pathway with preparation for the maximal supportive care pathway in this group.  An additional observational arm of the study aims to broaden knowledge further by including patients who have already chosen their pathway.  By creating the largest cohort to date of older patients preparing for either pathway, the team hope to identify markers that will help older patients to find their most beneficial treatment pathway
  • Dr Jason Wilkins is a principal investigator at King’s for the PAVE study: Paclitaxel assisted balloon Angioplasty of Venous stenosis in haEmodialysis access (PAVE).  A double-blind randomised controlled clinical trial to determine the efficacy of paclitaxel-assisted balloon angioplasty of venous stenoses in haemodialysis access.
  • Dr Hugh Cairns is a principal investigator at King’s for the DIDO study to determine the efficacy and safety of a Double Icodextrin Dose in elderly incident CAPD patients on incremental peritoneal dialysis therapy.
  • Federica Picariello (NIHR-BRC PhD student at KCL) is studying the psychological aspects of fatigue in dialysis patients, using mixed methods.

 Studies in the Research Laboratory

    • The research laboratory at King's is led by Dr Claire Sharpe and Dr Qihe Xu. Some chronic kidney diseases gradually get worse over time causing kidney failure. The kidney laboratory based at King's College Hospital is studying potential new drugs for slowing the progression of chronic kidney disease. Specific areas under study include:
    • Examining Chinese herbal medicines for their anti-scarring effects in the kidneys (some Chinese herbs can also cause kidney deterioration so please do not try these without seeking medical advice)
    • Looking at the role of vitamin A in kidney disease
    • Looking at drugs that block certain calcium channels and investigating whether these can be used in the treatment of chronic kidney disease.
    • Examining ways in which gene therapy designed to remove a disease-causing protein called Ras in the kidneys can help in preventing kidney failure from scarring and cyst formation.

Updated Aug 2018