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
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 lead investigator for both the PIVOTAL and the PEDAL trials. The PIVOTAL study is aiming to determine the optimum amount of IV iron to give a dialysis patient, while the PEDAL trial is investigating the potential benefits of cycling on a stationary bike during dialysis sessions. Along with the clinical research team, he is also investigating a new class of drugs for treating kidney anaemia, called HIF stabilisers. He is currently co-supervising 3 PhD students at King’s College, two doing projects related to hepcidin, the major regulator of iron availability in the body, and one investigating psychological factors affecting fatigue in dialysis patients.
- Dr Claire Sharpe is one of twelve investigators across the UK studying new ways to monitor kidney function. With the help of the research team she has recruited over 100 kidney patients representing the various ethnic mix in the local population. These patients will be studied for three years and the investigators hope to discover new ways of measuring kidney function more accurately and predict who will remain stable and whose kidney function will deteriorate over time.
- Dr Sharpe is also working with the department of haematology to study kidney disease in people with sickle cell disease. They are studying which genes a patient carries and how these affect their chances of developing kidney problems as a result of sickle cell disease. To find out more please contact Dr Sharpe: email@example.com
- 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.
- Dr Kate Bramham is working with Dr Nitesh Narvekar (Assisted Conception Unit) to investigate ovarian reserve and fertility in women with CKD to determine the use of standard biomarkers in renal disease, and risk factors associated with early menopause.
- Dr Kate Bramham and Dr Sapna Shah are leading a multi-centre study investigating the development of Anti-D antibodies after transplantation in order to inform the use of prophylactic treatment with the aim of preventing haemolytic disease of the newborn in future pregnancies.
- 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.
- Dr Kate Bramham is collaborating with Mr Nick Kametas (Obstetrician) and Dr James Leiper (MRC Centre for Nitric Oxide Signalling) to explore the contribution of nitric oxide deficiency to poor placental development and vascular adaption in pregnancy in women with pre-existing vascular disease.
- Federica Picariello (NIHR-BRC PhD student at KCL) is studying the psychological aspects of fatigue in dialysis patients, using mixed methods. Her work involves examining the longitudinal trajectories of fatigue in HD patients, predictors of symptoms over time, and a qualitative study exploring patients' experiences, beliefs and behaviours around fatigue.
- This work will then inform the development and testing of a psychological intervention designed to help support patients manage their fatigue. Federica is supervised by Dr Joseph Chilcot, Prof Rona Moss-Morris and Prof Iain Macdougall.
- Dr Richard Hull is the principal investigator at King’s for the RITUXILUP study in patients with SLE. This study is investigating whether an antibody treatment called Rituximab is effective in treating lupus nephritis when given with MMF, but without oral steroids.
- Dr Helen MacLaughlin (Consultant Dietitian) was awarded an National Institute of Health Research (NIHR) fellowship to lead a study to examine the feasibility of recruiting patients to have follow up checks of their kidney function after an episode of acute kidney injury (Ob AKI feasibility study). We have conducted this study at both the Denmark Hill and Princess Royal sites. The study has reached full recruitment and is in the final stage of follow up.
- Dr MacLaughlin is also working with teams from King’s College London and St Helier Hospital on research projects related to blood glucose control with nutritional support drinks in haemodialysis patients with diabetes (GRO-HD) and in validating a malnutrition screening tool (iNUT) for patients admitted to renal inpatient wards. Both of these studies are due for completion in 2016.
- Dr Sharlene Greenwood recently completed a NIHR-funded exercise study (The ExeRT Study) investigating the possible benefits of different types of exercise training in kidney transplant recipients. Ellen O’Connor, Rachel Tuffnell, and Kathryn Huang also completed Masters in Research (Mres) awards as part of the study. Dr Greenwood is also conducting a study evaluating the use of pulse wave velocity as a predictor for acute kidney injury (AKI) in patients undergoing coronary artery bypass graft surgery.
- Kelly Wright is the principal investigator for the RISK study at King’s. This is a prospective national, multi-centre study to collate data on all acute medical admissions in participating centres to develop a national risk assessment for AKI in secondary care. Data is collected on all admissions to MAU over a 24hr period.
- Dr Jason Wilkins is a principal investigator at King’s for the PAVE study. The study is investigating the efficacy of paclitaxel-assisted balloon angioplasty of venous stenosis in haemodialysis access.
Eleri Wood, Kidney Nurse Consultant, is leading a novel pilot study examining the impact of help from trained experienced kidney patients (peer supporters) on people who start dialysis suddenly. She is also the local lead for the national SPEAK study (Surveying People Experiencing young Adult Kidney failure).
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 Sept 2016