The NIHR is the nation's largest funder of health and care research and provides the people, facilities and technology that enable research to thrive. We work in partnership with the NHS, universities, local government, other research funders (including industry and charities), patients and the public to improve the health and wealth of the nation.
In 2017/18, the NIHR spent £9.3 million on research studies into renal and urogenital disorders through our research programmes. Last year (2018/2019), the NIHR Clinical Research Network (CRN) supported 226 studies on kidney disorders, 85 of which were new studies, and recruited 24,432 patients to kidney disorder studies.
The NIHR Health Technology Assessment (HTA) programme funded the largest trial in Antibody Associated Vasculitis (AAV) undertaken to date. PEXIVAS looked to improve patient survival and reduce the frequency of kidney failure in patients with ANCA associated vasculitis. The study outcomes resulted in cost savings in the NHS, as well as, improved patient outcomes. CRN Kidney Disorders supported this international multi-centre study by recruiting 178 participants in good time, exceeded its recruitment target across 19 sites in the UK.
The SUSPEND study was a multicentre, randomised, double blind, placebo-controlled trial which looked into the use of drug therapy in the management of symptomatic ureteric stones in hospitalised adults. The study was designed to determine whether the use of medical expulsive therapy (MET) is worthwhile for the NHS in terms of increasing the likelihood of spontaneous stone passage, and being cost-effective compared with standard care without MET.
This ground-breaking study is investigating the optimum amount of intravenous iron that kidney patients on dialysis should receive. This is the largest clinical trial that has ever been conducted in renal units in the UK. CRN Kidney Disorders has aided by assisting in setting up sites across the UK that can deal with large trial demands, as well as providing access the 2,080 patients across the UK and the principal investigators and research nurses from all the participating renal units.
£2.1 million has been awarded by the NIHR and the Department of Health and Social Care to conduct a four year programme of research investigating the clinical and cost effectiveness of intra-dialytic exercise as an adjunct therapy for maintenance haemodialysis patients.
The NIHR Devices for Dignity MedTech Co-operative is collaborating on a project to test whether taking regular measurements with a bioimpedance device improves outcomes for people who have recently started haemodialysis treatment for their kidney failure.
In particular the team wants to see if this helps maintain their remaining kidney function as this is associated with improved survival, fewer symptoms of kidney failure, fewer side effects of the dialysis treatment and a better quality of life. The project will also investigate whether sharing the bioimpedance information with patients leads to greater involvement and participation in their treatment.
Cardiovascular disease related to chronic kidney disease (CKD) is thought to cost the NHS in England £175 million a year. With end stage CKD growing at an estimated 6% a year, diagnosing and treating CKD effectively as early as possible is hugely important.
Researchers at the NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands developed a software tool called IMProving Patient Care and Awareness of kidney disease progression Together (IMPAKT), which analysed pre-existing general practice data more efficiently to identify patients at risk from CKD.
The NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester collaborated on projects to help GPs identify cases of early stage CKD, using manual MiQuest queries run on general practice IT systems.
The synergy between the two CLAHRC projects resulted in a collaborative project to bring together the IMPAKT software tool and the improvement package used with Greater Manchester practices. This resulted in the development of a CKD improvement support website - Improving Patient Care and Awareness of Kidney disease Together (IMPAKT).
You can find out more about research studies in your area through the Be Part of Research website.
There is around three million people in the United Kingdom living with chronic kidney disease, with over 60,000 people being treated for kidney failure. Every year in the United Kingdom, more than 5,000 people are waiting for kidney transplants, and almost 30,000 people are on dialysis.
Kidney Disorders research matters. It has meant:
The NIHR provides researchers with the practical support they need to make clinical studies happen in the NHS. This support covers every stage of research, from set up to delivery.
We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.
We support the set up and delivery of clinical research in the NHS through our Study Support Service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.
The Kidney Disorders Specialty is one of 31 specialties which bring together communities of clinical practice to provide national networks of research expertise and clinical leadership. It is made up of research-interested clinicians and practitioners who work at both national and local levels to ensure the studies that are included in our national portfolio of research are delivered successfully in the NHS.
Each of our 15 Local Clinical Research Networks has at least one nominated local Clinical Specialty Research Lead for Kidney Disorder studies. These clinicians lead research groups to promote and support Kidney research within the NHS Trusts in their area.
At a national level the local leads come together to manage the national Renal clinical research portfolio. This involves regularly reviewing the progress of studies, identifying barriers to recruitment, and coming up with solutions and strategies to help overcome those barriers. Our National Specialty Group of clinical experts offer advice and support to commercial and non-commercial customers looking to conduct research in the NHS.
Research involving benign conditions or the urinary tract are also managed under the auspices of the Kidney Disorder specialty group. There are three UK based consultant urologists who are panel members of the renal specialty group, who also lead a community of Urologists across the 15 Local Clinical Research Networks to ensure that benign urological research studies receive the necessary support.
Our Kidney Disorders Specialty profile gives an overview of our offer to the Life Sciences industry.
CRN Renal Disorders benefits from consistent and innovative interaction with other key renal stakeholders, especially its main charity, Kidney Research UK and the academic body, UK Kidney Research Consortium. This ensures that study development, funding and delivery are considered together.
We are working together to define the research agenda, identify and support new clinical researchers and promote patient involvement in study design, delivery and recruitment.
We also have several successful networks in the fields of urology and chronic kidney disease with UK wide studies ongoing. Our established network of principle investigators also have the knowledge, resources and infrastructure to permit participation in early phase studies.
Clinical research is being undertaken across the United Kingdom. We continue to work closely with the Scottish, Welsh and Northern Irish clinical research networks to support the design and delivery of high quality research.
The UK Kidney Research Consortium, is made up of leading kidney charities, professional associations, and NHS representatives – including the National Institute for Health Research.
Kidney Research UK, as the major charity funding research into renal disease, and the Renal Association, the professional body for renal physicians and scientists in the UK, were ideally positioned to begin this coordinated approach. Together they established the UK Kidney Research Consortium to support the development of clinical research in kidney diseases in the UK by advising on research needs and encouraging the development of new trials. The consortium immediately began building working relationships with NIHR clinical research infrastructure across the country, and this has since led to huge improvements in the coordination of renal research.
The CRN Renal Disorder Specialty Group were consulted throughout the development of the first UK Renal Research Strategy in 2016. There was a strong desire to see a significant emphasis on larger, more robust, UK clinical trials in nephrology in the strategy. The views of the group were taken into account and have helped shape the final strategy.
Kidney Research UK is the leading charity dedicated to research into kidney disease in the UK.
The Renal Association is the professional body for United Kingdom nephrologists (renal physicians, or kidney doctors) and renal scientists in the UK.
The UK Renal Registry (UKRR) is part of the Renal Association, a not for profit organisation registered with the Charity Commission.
We are recognised as having one of the very few high quality clinical databases open to requests from researchers. The UKRR collects, analyses and reports on data from 71 adult and 13 paediatric renal centres.
The BURST Research Collaborative is a research group comprising primarily of Urological Registrars in the UK aiming to produce high impact multi-centre audit and research which can improve patient care.
The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.
NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments. The following BRCs undertake research in renal disorders:
NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MICs undertake research in renal disorders:
All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: firstname.lastname@example.org
Our experts in the NIHR Clinical Research Network (National Specialty Leads) can give advice on delivering your kidney disorder study in the NHS.
Prof David Wheeler is Professor of Kidney Medicine at University College London, UK and Honorary Consultant Nephrologist at the Royal Free London NHS Foundation Trust.
He is a clinician scientist interested in the complications of chronic kidney disease, specifically those that increase the burden of cardiovascular disease and/or accelerate progression of kidney failure. David has participated in the development and running of several large-scale clinical trials testing lipid lowering regimens, calcimimetics and sodium glucose cotransporter 2 inhibitors in patients chronic kidney disease.
Other roles include Honorary Professorial Fellow of The George Institute (based in Sydney, Australia) with a remit to support this organisation’s clinical trials activities in Europe. David has been involved in the development of Clinical Practice Guidelines for several organisations, most recently for Kidney Disease: Improving Global Outcomes (KDIGO) He has served as KDIGO co-chair between 2012 and 2019. He is Past President of the UK Renal Association and past chair of the UK Renal Registry.
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