Working together to improve kidney treatments
Together, we can transform treatments for children with kidney disease
When children’s kidneys fail, they face a lifetime of kidney failure. A transplant is not a cure. Even after a transplant, children need a lot of specialist monitoring, medicine and treatment, and they are more vulnerable to other serious illnesses.
“Daniel is likely to need several transplant operations in his lifetime, with bouts of dialysis in between. Preparing for this, I always make sure that all Daniel’s blood tests are done on the same arm, to keep the veins of his other arm in good condition for when he needs dialysis in the future.”
Louise Paton, Daniel's mum
That’s why it’s so important to find new ways to transform kidney treatments. Every advance we make improves life for children like Daniel.
The project: improving dialysis lines in children
When a child’s kidneys have failed, he or she is connected to a dialysis machine several times a week. The machine does the job their kidneys can’t do: cleaning toxins from their blood and getting rid of extra water from their body.
In the UK, about 50% of children with kidney failure have a type of dialysis called haemodialysis. In haemodialysis, a plastic catheter is inserted into the child’s heart through one of the large blood vessels in their neck. The other end of the catheter is connected to the artificial kidney machine. Inside the catheter there are two separate tubes (called lumens) – one of them transports blood from the child to the machine, and the other brings the cleaned blood back.
45% of dialysis lines in children get infected and need replacing, which means a surgery under general anaesthetic. This can permanently damage the child’s blood vessels. Dialysis lines for children are a miniaturisation of adult lines. But children’s anatomy is quite different.
What if a better dialysis line could be designed?
“My job is 50% clinical and 50% research work, and I absolutely love that combination. It gives me the time and opportunity to take the questions and challenges that we come across at the bedside and formulate research questions to explore them further.”
Dr Rukshana Shroff, a kidney specialist at Great Ormond Street Hospital
“The evolution of computer capabilities allows us to treat patients in a completely new way. I use MRI, CT and ultrasound scans from patients to build 3D computer models, and 3D printed models in a variety of materials. Clinicians and surgeons then use these models to study a problem, find solutions, or practise surgeries.”
Dr Caudio Capelli, a biomedical engineer at Great Ormond Street Hospital.
The project will study existing lines thoroughly and test new designs with a variety of modifications. This testing can’t be done inside a patient, but the conditions inside a child’s heart and blood vessels need to be created as accurately as possible in the lab to make the tests effective. By bringing together Rukshana and Claudio’s unique skills, this project is a big step towards improved treatment for child patients.
“This project is very much a double act between us. It is identifying clinical problems and then finding bioengineering solutions to make them better.”
Rukshana submitted a research proposal to Kidney Research UK for £40,000 to fund the project. We saw huge potential for improving lives and awarded a grant earlier this year.
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