This page shows examples where our renal research has translated into NHS practice, service or policy. It also shows examples of innovative research aimed at improving the life of patients.
Finger blood test to estimate renal function
The South West Institute for Renal Research has successfully developed a finger prick blood spot test for estimating renal function (glomerular function rate, GFR).
Patients provide spot blood samples at home on filter paper which are posted to the Renal Institute and are used for measurement of iohexol. This method which was developed with a grant from the National Kidney Foundation has now been fully validated.
The renal researchers are now utilising this method in a study of South Asian individuals at risk of renal disease. The study, in collaboration with Hammersmith Hospital, is a good example of bench to bedside research.
Long-term success of surgically-fashioned fistulae
In another study, researchers in the Renal Institute investigated the factors affecting the long-term success of surgically-fashioned fistulae which are used for patients requiring haemodialysis.
Over a period of two years it was found that fistulae in patients who had been assessed and operated by specialist registrars achieved the national rates of long term patency but that those assessed and operated on by consultants did significantly better.
As a result of this study, a consultant-led care pathway has been instituted and all patients are assessed initially by a consultant who will allocate suitable patients to the registrar. This change of practice will be subject to re-audit.
Dialysis for elderly patients with co-morbidities
In a collaborative study with Guys, Kings College and St George's hospitals, the outcome for elderly patients with co-morbidities undergoing dialysis was investigated.
All patients aged 75 or older attending pre-dialysis clinics received counselling regarding further treatment options and the outcomes in those receiving dialysis were compared with those who chose conservative measures.
Whilst patients receiving dialysis lived, on average, longer than those managed conservatively, the subgroup with co- morbidities (typically ischaemic heart disease) fared no better on dialysis or on conservative measures.
This study has helped inform decision making in South London and has been incorporated in the education days for patients, advice given to patients and guidance for clinicians.
Study to develop new test to predict infections
A current bench to bedside study aims to develop a test which will predict clinically serious line infection in patients with
intravascular ports such as patients on dialysis. Using a multiple cytokine analyser, a bank of cytokines can be estimated on a single blood spot sample.
Patients at high risk of bacteraemia especially MRSA infection, show changes in cytokine responses before severe sepsis develops. Currently the cytokine assessments are being validated supported by charitable funds.
An application to the National Kidney foundation is planned to take the work forward. St Helier Hospital is one of three participating centres in a study examining issues around quality of life in older patients in dialysis, sponsored by Kidney Research UK.
