Kidney Research UK

The 2004 programme was chaired by Professor Neil Turner, Professor of Nephrology at Edinburgh, and covered a wide range of talks allowing us to gain valuable insight into the large variety of areas and projects that the Fund has been and is currently funding. A fascinating guest lecture by Professor Nick Hastie also from Edinburgh, on The Wilms' Tumour 1 gene, mutations of which lead to a wide array of conditions from glomerulosclerosis and renal tumours to gonadal dysgenesis, was an apt start to an interesting day. His team are employing a number of novel techniques including the use of siRNA in kidney organ culture and Optical Projection Tomography to allow 3D reconstruction of anatomy, which could be applied to many of the areas of research that those of us supported by the Fund, are undertaking. There then followed three talks by Training and Career Development Fellows covering subjects from cell-to-cell communication in renal collecting duct cells to a new model of small vessel vasculitis which may extend our understanding of the underlying mechanisms and potential treatments for this rare but potentially life-threatening disease.

After lunch a talk by Jeremy Nicholls, a patient on haemodialysis, swiftly took us away from basic science and back to the realities of living with renal failure. He started dialysis in 1978 and since that time has had more than 24 operations including two transplants and feels constantly tired and dizzy. Despite all of these significant hurdles he treats himself as a 'normal' person and has managed to complete 'O' and 'A' levels, a degree and runs two businesses whilst on dialysis. He knows, as we all too clearly realise, that doctors do not have the answer to everything. He stated that healthcare is about partnership, concensus and talking to one another which is an area that we all should regularly strive to improve upon. He concluded with the phrase 'hope is the key to a happy life' and that this is given to him, at least in part, by doctors and scientists. This powerful message brought back to mind the importance of translational research and that those of us involved in investigating at the cellular or molecular level need to constantly reconsider how the knowledge we glean can be translated into the prevention or treatment of disease and in doing so, help patients.

In contrast to the previous talk the next three presentations were given by three different types of research fellow. The first by Ahmed Akl an International Society of nephrology / NKRF research fellow based in Oxford, who has demonstrated the likely importance of regulatory T cells in protecting stable renal transplants. This was followed by Wing-Kee Lee, one of the 31 PhD students that the Fund has supported in the last few years. Lastly, Catherine Boulter from Cambridge, a recipient of one of the coveted Senior Research Fellowships, spoke on her work investigating the molecular basis of Wilms' Tumour which is the most common solid tissue tumour of childhood.

The formal programme for the first day was concluded by the Chief Executive, Charles Kernahan who set out his refreshingly positive mission statement for the future of the Fund. He hopes to increase the efficiency of fundraising operations, expand the relationship with Corporate and Trust donors and ultimately aims to boost funding by more than 50% in the next three years. He talked about the breadth of activity supported and clarified that whilst the majority (up to 75%) of charitable expenditure is still spent on funding research, significant funds also go towards caring for patients more directly and raising awareness of kidney disease. This latter point is highlighted by the ABLE programme which is targeted at minority ethnic communities and focuses on awareness and educational activities and is co-funded by the Department of Health.

To end the first day we were transported to Castle Fraser, Inverurie for a drinks reception and dinner in the great hall.

The following morning session convened with discussion on training and career development issues. Firstly Professor Peter Mathieson, Chairman of the Fund's Research Grants Committee gave us an update on the Fund's Fellowship Programmes and conveyed the difficulties faced in deciding which type of Fellowships should be prioritised. For example, senior fellowships (particularly clinical ones) are very expensive and many PhD students could be funded for the cost of one clinician scientist: where should our priorities lie? At present two-thirds of projects cover basic science with only a third on clinical matters: is the emphasis particularly on immunological basic science the right way forward? These are important questions that The National Kidney Research Fund will have to consider over the next few years.

David Carmichael, Chairman of the Specialty Advisory Committee of the Joint Specialty Committee on Renal Disease, spoke about reconciling research and clinical training. The conflicting pressures of clinical training, particularly with the drive to shorten the length of training and the desire to pursue an academic career are all too apparent. He spoke on the need to question whether every renal Specialist Registrar (SpR) needs to obtain an MD or PhD particularly in view of the expansion of SpR numbers. He also discussed what effect the European Working Time Directives may have on research training.

Next up was a careers advice talk by Professor John Mullins on establishing a career as a basic scientist. He spoke about the difficulties and challenges involved in setting up a research career and highlighted some important points. It is important to be confident and at least a little single-minded but also to choose a good mentor to listen to and to work within a high-quality infrastructure. However, if you are committed and excited by your research then it can be a very fulfilling career.

These lectures were followed by 13 poster presentations by Fellows covering areas including the immunological basis of renal disease, tubular physiology, and candidate genes for congenital conditions. The day was concluded by a talk by Dr Steven Swanson, Director of Clinical Immunology from Amgen US on monitoring the immunogenicity of therapeutic proteins which created much discussion amongst the clinical members of the audience who use many of these proteins on a regular basis.

In summary, my feeling from the meeting is that The National Kidney Research Fund is actively moving forward. There are a number of decisions to be made but the mission statement to fund innovative research, to care for patients and to raise awareness of kidney disease is increasingly being realised.