Spotlight on our science
Before the coronavirus pandemic hit we had just invested almost £0.8m in partnership with The Stoneygate Trust into a new round of research that will shape the future of kidney disease and bring hope to patients now and for years to come. The projects below are a selection which were part of the 2020 Stoneygate and Kidney Research UK award.
Using sound as an alternative to biopsy
As chronic kidney disease (CKD) progresses, kidney tissue becomes harder through a process called fibrosis, or scarring. We can. We can see how severe CKD is by measuring this hardening effect. Usually, this means taking a tissue biopsy.
But a biopsy is invasive, can be painful and carries risks, meaning it can’t be done very often in the same person. Also, kidney biopsies only take a small section – less than one per cent of the kidney – meaning they could miss the most diseased part of the organ.
Magnetic resonance elastography (MRE) is a relatively new technology that uses magnetic resonance imaging (MRI) to measure tissue elasticity. It’s like a more advanced ultrasound. MRE works by sending sound waves into the body to build up a picture of what’s inside with the help of a computer.
Scientists at the University of Nottingham, led by Professor Susan Francis, will optimise MRE to better estimate kidney hardness caused by fibrosis. This technique will allow doctors to monitor CKD progression in people with a kidney transplant without the need for a biopsy.
This research is funded by a research project grant of £49,075.
Can a drug help to prevent kidney damage?
Glomeruli are the kidney’s filters. They are microscopic balls of tiny blood vessels, known as capillaries, whose walls have special adaptations to enable them to act as biological sieves. The sieves are designed to allow water and small waste products through into the urine but retain blood cells and large molecules such as proteins in the blood stream. A gel-like layer known as the glycocalyx forms the first component of these sieves. Diseases that affect the glomeruli can cause that sieve to leak, eventually leading to kidney failure.
Professor Simon Satchell at the University of Bristol and his team have found that in diabetes and other conditions, the glycocalyx becomes damaged by particular enzymes called matrix metalloproteinases or MMPs. These enzymes act as chemical scissors that remove the glycocalyx. If we can stop these enzymes working then the glycocalyx is protected and the leakage is reduced.
Simon will determine whether an existing antibiotic can prevent glycocalyx damage.
This antibiotic is already known to be safe in humans, so if they can show that it works, it could potentially be used to treat kidney disease much sooner than any newer treatment.
This research is funded by a research project grant of £91,307.
Monitoring kidneys before and after a transplant
When you remove a kidney ready for transplantation, it can become damaged, to the point where it is not healthy enough to be given to someone else.
This damage occurs from both the lack of oxygen and changes that happen when the supply of blood is reconnected. The kidney goes into a state of stress because it doesn’t have enough oxygen and the kidney starts to make cells called chemokines, which can damage the kidney further.
We need new ways to check how much damage is being caused to the kidney through lack of oxygen. Professor Simi Ali and the team at Newcastle University will look at urine and blood to detect the level of chemokines released by the kidney and compare this to the level of damage.
Once their methods have been established, they will test it in a much larger selection of patient samples so that patients who are at higher risk of early transplant problems can be picked up earlier and interventions can be put in place.
This research is funded by a research project grant of £49,965.
Understanding depression in people with chronic kidney disease
Mental health problems are more common in people with chronic kidney disease (CKD) compared to the general population. People with CKD who experience depression frequently have poorer physical health, a lower quality of life and can even die younger, compared to people with CKD who do not have depression.
Sadly, right now, we don’t know how best to treat depression in CKD patients. There are general guidelines for people with long term conditions with depression, but we don’t know if these guidelines are used, or if they’re helpful in people with CKD.
Dr Joseph Chilcot at King’s College London wants to change that. Joe and the team will start by looking at existing ways that people with long term conditions and depression are treated. Then they’ll create a questionnaire (with help from experts, carers, kidney patients and health care professionals) to send to all of the UK renal services, to understand how they treat adults with CKD and depression.
Their findings will be discussed with an expert panel so that they can develop the best practices and make recommendations for a new pathway of care for people with CKD and depression.
This research is funded by a research project grant of £223,262.
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