Team gets to heart of kidney disease

01 November 2012

Dr Jonathan Townend

Dr Jonathan Townend

A team of QEHB researchers is leading efforts to better understand a health condition believed to kill around 45,000 people and cost the NHS up to £1.45 billion every year.

Chronic kidney disease (CKD) is a condition in which the kidneys become less effective at filtering waste products from the blood and, if the kidneys completely cease working, the patient can require dialysis and even transplantation.

Most patients with CKD have few or no symptoms and can be managed with tablet treatment and monitoring.

Early stage CKD probably affects around ten per cent of the population.

A recent report in Nephrology Dialysis Transplantation suggests CKD contributes to around 45,000 premature deaths in the UK every year.

In CKD there is an increase in the rate of various cardiovascular diseases. To investigate this link, QEHB experts formed the Cardio-Renal Research Group in 2005.

It is led by cardiology consultants Dr Jon Townend and Dr Rick Steeds and nephrology consultant Dr Charles Ferro.

Dr Charles Ferro

Dr Charles Ferro

Dr Townend said the work could have a major impact: “We know that, like people with high blood pressure, those with kidney disease have few symptoms but are at greatly increased risk of heart disease.

“It’s important that we do this cross-disciplinary work. What nephrologists manage is kidney disease and what cardiologists do is heart disease; this group is about bringing that expertise together.

QEHB is uniquely positioned to do this work because it combines world class kidney and heart treatment and research on one site.

“This is one of the things we should be good at because of the opportunity for cross-disciplinary work here. And we have had some good results,” said Dr Townend.

“We’re not looking at patients on dialysis; we’re looking at those with much lower level kidney disease. Around 13 per cent of the population are walking around with impaired renal function but they’re not feeling sick.

“Like with high blood pressure, there aren’t many symptoms but there’s still a high risk of cardiac disease.”

Dr Rick Steeds

Dr Rick Steeds

The group employs clinical research fellows Will Moody, Khai Ng and Colin Chue, lecturer Dr Nicky Edwards and has three main themes of work.

The first theme looks at a drug called Spironolactone to prevent heart and blood vessel damage by interfering with the action of a hormone called aldosterone.

This hormone is produced excessively by people with CKD and may damage the heart, kidneys and blood vessels.

A second theme examines phosphate binding drugs to help CKD patients’ bodies remove phosphate from the bloodstream.

When retained, phosphates appear to lead to cardiac and vascular disease, and are removed by healthy kidneys.

The third theme looks at kidney donors to see how changes in kidney function might affect blood vessel and heart health.

Researchers suspect there might be subtle cardiovascular effects after donating a kidney, although current studies show kidney donors have a completely normal life expectancy after donation.

The group’s work is expanding and receiving national and international recognition, including several grants from the British Heart Foundation and the National Institute for Health Research.