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Kidney disease ends here.

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Our research progress in action

12 April 2021

Before the pandemic took hold, we funded some exciting research grants. This work continues, as our scientists work hard to stop kidney disease destroying lives. See examples of our work in action below.

Can kidney cells switch roles and does this process go wrong in kidney disease?

Each part of your kidney has specialised cells that do specific jobs. The collecting duct, which carries waste from the kidney’s filters out to the bladder, has two types of cells. Principal cells ensure our sodium levels are balanced, and intercalated cells keep our acidity levels balanced.

Scientists have recently discovered additional cells that are ‘in transition’ because they have both these properties. They believe principal cells and intercalated cells can switch roles with each other – a process we call ‘cell plasticity’.

With our funding, Professor John Mullins and his team at the University of Edinburgh will confirm whether there is a relationship between the two cells (see image courtesy of Dr Adrienne Assmus) and if they are able to change their functions. They will study these cells in detail and work out if their properties change in healthy and diseased kidneys, how they do this, and if this process is different in unhealthy kidneys.

Principal and intercalated cells in the kidney
Principal and intercalated cells in the kidney. Image courtesy of Dr Adrienne Assmus

If this project reveals cells can change and that the process is different in kidney disease, it may uncover new ways to treat kidney disease by intervening in the transition process.

John’s work is funded by a research project grant for £179,230 which ends in July 2021.

Could our body clocks reveal the best time to give kidney treatments?

Chronic kidney disease, or CKD, is when your kidneys become damaged, and it can lead to kidney failure. One of the most common causes is glomerular disease, which affects the tiny filters in the kidney called the glomeruli. These usually keep important proteins in the blood, but in glomerular disease, they become leaky and protein escapes into the urine.

Urine protein levels and kidney filtration rate vary throughout the day, and this pattern coincides with our daily rhythm, or our body clock. This 24-hour internal clock runs in the background of your body. The most well-known body clock is the sleep-wake cycle, but there are other biological clocks in the body too.

Dr Rebecca Preston from the University of Manchester thinks there is a link between glomerular disease and disruption of your kidney’s body clock, which makes the kidneys more leaky. Her research project will investigate the daily rhythm of the kidney filters in mice, and they will hunt for genes in the kidney which might be controlled by our body clock.

clock

The Manchester team hope that by understanding more about how the body clock controls the kidney filters, they can guide development of new treatments, including what time of day is best for people with kidney disease to receive them.

Rebecca’s work is funded by a clinical training fellowship for £231,802 which ends in October 2023.

Developing a new scan to spot and monitor dialysis side effects

For patients with end stage kidney disease, haemodialysis is their lifeline. But it also brings problems, and sudden issues with the heart are among the most feared. Over time, the heart muscle can become scarred and the extent of the scarring predicts whether someone is likely to have problems with their heart rhythm, which can sometimes even be fatal.

With our funding, Professor James Burton, Dr Matthew Graham-Brown and the team at the University of Leicester have been looking at how best to measure scarring caused by dialysis. They can’t perform the usual MRI scan used in checking heart disease, because it uses a contrast dye which is harmful to people with kidney failure, but they have discovered a new MRI technique called native T1 mapping that may work instead.

In this project, they will find out if this technique can accurately measure heart scarring in those on dialysis. They’ll do this by comparing scans from people on dialysis, with scans of donated hearts from dialysis patients who have passed away, which have also had biopsies taken and been tested in the lab.

Patient waiting for MRI scan with doctor

A new scanning method that accurately detects scarring could offer hope to those on dialysis. It may reveal a new way to monitor this unpleasant side effect of treatment and help us find ways to prevent sudden, and potentially fatal problems with the heart.

James’ work is funded by a research project grant for £47,744 and is due to complete in February 2023.

Understanding how dialysis affects blood vessels/heart disease.

Having chronic kidney disease places strain on your heart, increasing your risk of having a heart attack by three to four times. If you are a young adult on dialysis, you are more than 100 times more likely to die of a heart attack or a stroke than your peers who are healthy. These are shocking statistics which London-based trainee doctor Isaac Chung wants to change.

Treating the usual suspects that increase the risk of heart attacks and strokes - including diabetes, blood pressure and an unhealthy lifestyle - has only partially helped to lower these statistics. Plus, we don’t yet fully understand how blood vessel changes cause heart attacks and strokes, and how quickly these changes happen in people with kidney disease.

Isaac, a trainee doctor at St George’s, University of London, has studied how blood vessels change in the short term, over three to six months of dialysis, but no one has studied longer-term changes and how to resolve them. In this research project, Isaac will look at blood vessel changes by doing an ultrasound test of the blood vessels in the arm, legs and the neck of people with kidney disease.

Person on dialysis
Person on dialysis

He hopes his project will tell us more about blood vessel changes and how they progress, and the risk factors underpinning them. This work may reveal new ways to prevent heart attacks and strokes in the future.

Isaac’s work is funded by an intercalated degree for £5,000, which ends in September 2021. 

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