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Cardio-renal clinical study group

Patients with kidney failure are at a very high risk of heart disease, including heart attacks and stroke, compared to the general population. This risk starts even when kidney function is only slightly abnormal and increases dramatically in patients who need dialysis. 

Although some of this risk is explained by well-known risk factors such as high blood pressure and diabetes, this does not account for why patients with kidney disease are at such high risk. Further research to explain this, and develop better treatments is required. 

Who we are

We are a national group dedicated to initiating and supporting clinical research in the cardio-renal field. 

The group is led by Co-Chairs, Dr Tim Doulton, Consultant Nephrologist at East Kent Hospitals University NHS Foundation Trust Renal Unit, and Dr Matthew Graham-Brown, Associate Professor of Renal Medicine, University of Leicester and Honorary Consultant Nephrologist at University Hospitals Leicester. 

We are delighted to have new members, and are interested in studies proposed from out with the group. 

Tim Doulton
Tim Doulton
Matt Graham-Brown
Matthew Graham-Brown

Our aims:

  • Developing a better understanding of and treatments for the cardiovascular complications of chronic kidney disease (CKD).
  • Addressing why patients with kidney disease are at such a high risk of heart problems (approximately 20 times higher than the general public of the same age).
  • Learning more about why patients with primarily cardiovascular disease develop kidney problems and to find better treatments to prevent this or manage this better.
  • Undertaking multicentre, collaborative studies and clinical trials in cardio-renal medicine to improve cardiovascular outcomes for patients with kidney disease. Evidence gaps and challenges:

Evidence gaps and challenges:

Ongoing studies:

Completed studies we helped to deliver:

Publications arising are listed below.

Our impact:

The studies above are helping define the best treatment strategies to prevent cardiovascular problems in patients with chronic kidney disease by using statins or medications used for heart failure or treating high blood pressure. They have informed National and International guidelines with a direct and measurable impact on patient care. In future studies we will explore different options such as vitamin k therapy or exercise programs to see if they provide additional benefits and help reduce the risk of heart disease risk in patients with kidney failure. 

A selection of publications

(past three years)

Rankin AJ et al. Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal. J Cardiovasc Magn Reson. 2021 Nov 11;23(1):125 

Edy E et al. Cardiovascular magnetic resonance for the detection of descending thoracic aorta calcification in patients with end-stage renal disease. J Cardiovasc Magn Reson. 2021 Jun 24;23(1):85 

Graham-Brown MPM et al. A randomized controlled trial to investigate the effects of intra-dialytic cycling on left ventricular mass. Kidney Int. 2021 Jun;99(6):1478-1486 

Lees JS et al. The ViKTORIES trial: A randomized, double-blind, placebo-controlled trial of vitamin K supplementation to improve vascular health in kidney transplant recipients. Am J Transplant. 2021 Oct;21(10):3356-3368 

Highton PJ et al. Intradialytic cycling does not exacerbate microparticles or circulating markers of systemic inflammation in haemodialysis patients. Eur J Appl Physiol. 2022 Mar;122(3):599-609 

March DS et al. A Cost-Effective Analysis of the CYCLE-HD Randomized Controlled Trial. Kidney Int Rep. 2021 Apr 8;6(6):1548-1557 

Lalayiannis AD et al. The burden of subclinical cardiovascular disease in children and young adults with chronic kidney disease and on dialysis Clin Kidney J (2021) 15(2): 287-294 

Lalayiannis AD et al. Studying bone mineral density in young people: The complexity of choosing a pQCT reference database Bone (2021) 143: 115713 

Bakkaloglu SA et al. Bone evaluation in paediatric chronic kidney disease: clinical practice points from the European Society for Paediatric Nephrology CKD-MBD and Dialysis working groups and CKD-MBD working group of the ERA-EDTA Nephrol Dial Transplant (2021) 36(3): 413-425 

Rankin AJ et al. Global longitudinal strain by feature-tracking cardiovascular magnetic resonance imaging predicts mortality in patients with end-stage kidney disease Clinical Kidney Journal (2021) sfab020 

Graham-Brown MPM et al. Differences in native T1 and native T2 mapping between patients on hemodialysis and control subjects. Eur J Radiol. 2021 Jul;140:109748 

Lalayiannis AD et al. Routine serum biomarkers, but not dual-energy X-ray absorptiometry, correlate with cortical bone mineral density in children and young adults with chronic kidney disease. Nephrol Dial Transplant (2021) 36(10): 1872-1881 

Price AM et al.; EARNEST investigators. Changes in Blood Pressure and Arterial Hemodynamics following Living Kidney Donation. Clin J Am Soc Nephrol (2020) 15(9): 1330-1339 

Witham MD et al. Vitamin K Supplementation to Improve Vascular Stiffness in CKD: The K4Kidneys Randomized Controlled Trial. J Am Soc Nephrol (2020) 31(10): 2434-2445 

Rutherford E et al. A Randomized, Controlled Trial of the Effect of Allopurinol on Left Ventricular Mass Index in Hemodialysis Patients. Kidney Int Rep. (2020) 6(1): 146-155 

Price AM et al.; EARNEST investigators. Changes in Blood Pressure and Arterial Hemodynamics following Living Kidney Donation. Clin J Am Soc Nephrol. (2020) S15(9): 1330-1339 

Potpara T et al. Management of atrial fibrillation in patients with chronic kidney disease in clinical practice: a joint European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) physician-based survey  EP Europace (2020): 22(3): 496–505 

Lalayiannis AD et al. Assessing bone mineralisation in children with chronic kidney disease: what clinical and research tools are available? Pediatr Nephrol (2020) 35(6): 937-957 

Lees JS et al. Vitamin K status, supplementation and vascular disease: a systematic review and meta-analysis. Heart (2019) 105: 938-945 

Lees JS et al. Glomerular filtration rate by differing measures, albuminuria and prediction of cardiovascular disease, mortality and end-stage kidney disease. Nat Med. (2019) 25: 1753-1760 

Macdougall IC et al. Intravenous Iron in Patients Undergoing Maintenance Hemodialysis. N Engl J Med (2019) 380: 447-458 

Shroff R. et al. Effects of Hemodiafiltration versus Conventional Hemodialysis in Children with ESKD: The HDF, Heart and Height Study. J Am Soc Nephrol (2019) 30: 678-691 

Shroff R et al. Effects of Hemodiafiltration versus Conventional Hemodialysis in Children with ESKD: The HDF, Heart and Height Study. J Am Soc Nephrol (2019) 30: 678-691  

Findlay MD et al. Investigating the Relationship between Cerebral Blood Flow and Cognitive Function in Hemodialysis Patients. J Am Soc Nephrol (2019) 30: 147-158 

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