60 years of life-changing research
This year marks our 60th anniversary: 60 years of fighting to end kidney disease through cutting-edge research. On this important milestone, we have handpicked some of our successes to celebrate together.
Dutch physician Dr Willem Kolff, known to many as the ‘father of dialysis’, constructed the first dialysis machine in 1943. With World War II in full force and materials scarce, Kolff was forced to be resourceful, and he used household items, including sausage skins, orange juice cans and a washing machine to make his first contraption to clear toxins out of the blood.
Since then, huge advances in dialysis machines, the materials and techniques used to gain access to patients’ veins, and the development of peritoneal dialysis in 1980, have meant that the lives of countless kidney patients have been saved.
Unlike pre-1960, different treatment options are now available to patients. In 2014, we introduced the Dialysis Decision Aid – a tool to help healthcare professionals and patients decide the best form of dialysis treatment to suit their lifestyle requirements.
Many kidney patients rely on haemodialysis to keep them alive. With our funding, Dr Rukshana Shroff from Great Ormond Street Hospital showed that a newer form of dialysis treatment – haemodiafiltration – is more effective, safer and better tolerated by children than conventional haemodialysis.
Whilst dialysis is a life-saving treatment, it is often also life-limiting. This year, we launched our ‘Transforming Treatments’ campaign, to improve quality of life for kidney patients and reduce the burden of treatment.
We are proud to have accelerated several breakthroughs in the treatment of anaemia, common in kidney patients. This means they don’t produce enough red blood cells and it can leave them feeling exhausted.
In the 1980s, we funded research by Peter Ratcliffe (now Sir Peter Ratcliffe). Peter studied how the kidneys control the gene affecting the production of erythropoietin (EPO) – a hormone that stimulates bone marrow to produce red blood cells.
This work led to the widespread use of manufactured EPO which has made a significant difference to the lives of kidney patients with anaemia and has enormous potential to help treat other diseases including cancer. Sir Peter was awarded the most prestigious award in science in 2019 – the Nobel Prize.
Although EPO has drastically improved the treatment of anaemia, many kidney patients on haemodialysis still require intravenous iron supplementation. Historically there was very little evidence for how much iron is safe and effective to give to kidney patients. Between 2013 and 2018, we facilitated one of the largest renal clinical trials ever undertaken in the UK – the PIVOTAL (Proactive IV iron therapy in haemodialysis patients) trial. The trial, led by King’s College Hospital, in partnership with Glasgow University Clinical Trials Unit, showed that giving haemodialysis patients a higher dose of iron was safe, effective and better for treating anaemia than giving a lower dose and that patients were less likely to die or have heart attacks, strokes or heart failure.
Since the UK’s first successful deceased donor and living donor kidney transplants in 1959 and 1960, respectively, we have had a key role in driving huge progress in transplantation research.
In 1992, with our funding, Professor Giovanna Lombardi at Imperial College London discovered that specific white blood cells called regulatory T cells (Tregs) might be able to prevent transplant rejection in patients with lupus. Giovanna is now working as part of an international consortium to test whether treatment with Tregs can reduce the number of immunosuppressive drugs transplant recipients require, and early results have shown that this therapy is safe in kidney patients.
Since 2010, our funding has enabled Professor Mike Nicholson and his team to develop a pioneering technique to increase the quality and lifespan of kidney transplants and this technique is currently being trialled in patients.
The technique, called ‘normothermic perfusion’, involves flushing the kidney with warm oxygenated blood before transplantation, to revive it and reverse any damage caused by cold storage. This has the potential to repair kidneys that would have previously been deemed too damaged for transplantation, increasing the available pool of donor kidneys.
Normothermic perfusion also offers a unique opportunity to deliver therapies straight to the kidney before transplantation. With our funding in 2020, Dr Emily Thompson from Newcastle University discovered that, when combined with normothermic perfusion, treatment with stem cells, called multipotent adult progenitor cells, can improve the quality and function of damaged kidneys.
In the last six decades, our knowledge of genetics has come a phenomenally long way, and this has fuelled some life-saving discoveries for kidney patients. In the early 1980s, researchers were beginning to map human disease genes. Dr Stephen Reeders, then a registrar at the Oxford Renal Unit, decided to do the same for autosomal dominant polycystic kidney disease (ADPKD) – a life-threatening inherited condition that can cause kidney failure – and he discovered and mapped the gene PKD1. Seeing the potential in his work, we funded Stephen and his team to investigate how faults in this gene could lead to ADPKD. Decades later, in 2015, as a result of this early research, the first ever pharmaceutical treatment in Europe for ADPKD – Tolvaptan – was approved.
Building our community
We are proud to invest in talent and fund opportunities throughout the career ladder to enable skilled students to become kidney researchers. However, we know we can’t end kidney disease alone and, especially in the last decade, we have harnessed the power of community by establishing networks, identifying alternative sources of funding and partnering with other charities and organisations to drive change.
In 2007, we joined forces with several kidney organisations to establish the UK Kidney Research Consortium (UKKRC), which fosters and drives collaborative clinical research into kidney disease. In 2016, the UKKRC published the first UK Renal Research Strategy, bringing together professional and patient organisations to identify areas where research is needed to deliver maximum benefits in the health and wellbeing of kidney patients and those at risk of kidney disease.
Tackling health inequalities has long been at the heart of our work and in 2019, we drew on experts across the UK to publish a report into kidney health inequalities in the UK showing that certain groups of people are at greater risk of developing kidney disease. This report brought into sharp focus the work needed to address the inequalities that lead to poorer kidney health outcomes.
In 2017, we led collaborative efforts to launch NURTuRE (the National Unified Renal Translational Research Enterprise) – the first UK kidney biobank. By collecting and storing biological samples from 3,000 patients with chronic kidney disease (CKD) and at least 800 patients with idiopathic nephrotic syndrome and linking these to clinical data through the UK Renal Registry, this resource will accelerate better understanding of kidney disease and development of new treatments.
In the last year, the kidney community has been challenged like never before in the face of the Covid-19 pandemic. We responded quickly to this critical need, in partnership with several other kidney charities, by funding two important studies to try to better protect kidney patients from Covid-19. The first investigating how well Covid-19 vaccines work in patients who go to hospital for their dialysis treatment, and the second examining whether a tapeworm treatment can prevent Covid-19 in vulnerable patients. We continue to work closely with these organisations to advocate for kidney patients and understand how best to keep them safe.
Living with kidney disease is relentless and can inevitably put a huge strain on mental health and wellbeing. Historically this has not been at the forefront of kidney medicine, but we are striving to change that.
In 2019, we supported Dr Alex Hamilton from the University of Bristol to conduct the Surveying People Experiencing young Adult Kidney failure (SPEAK) study; an online survey assessing challenges faced by young adults with kidney disease. The results highlighted the emotional impact of kidney disease on young people and Alex is now researching treatments and initiatives used to help young adults with other chronic conditions to see if they could help kidney patients.
With the extra challenges the pandemic has brought, focusing on mental health has never been more important. In May 2020 we partnered with the Centre for Mental Health, releasing a statement of intent outlining the actions needed to transform kidney services to support patients’ mental health.
During the first Covid-19 lockdown, kidney patients were more isolated than ever. We supported King’s College Hospital renal physiotherapist, Sharlene Greenwood, to launch and research whether Kidney Beam – a free online wellbeing service for people living with kidney disease – can help patients manage their physical and mental health. In May 2020, England and Manchester United footballing legend Andy Cole set up the Andy Cole Fund with us, to raise money for research into transplants and mental health support for kidney patients.
Long road ahead
We have come a long way in 60 years. Treatments for kidney disease have changed dramatically and many people can now live a long, fulfilling life. However, this is not the case for all kidney patients, we still have a long way to go. With your help, in the next 60 years, we will enable early diagnosis of kidney disease and early intervention, transform treatments, and make sure everyone in the country receives the same excellent quality of care. Kidney disease ends here.
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