Kidney Care Appeal

Research in the Clinic

Exercise Therapy to Improve Patients' Health in Advanced Kidney DiseasePhotograph of a lady on an exercise bike

Research supported byKidney Research UK Logo

Patients with advanced kidney disease commonly encounter serious problems in organs other than the kidney. These long-term effects of kidney disease include muscle wasting, heart disease and increased susceptibility to infections (arising from problems with the immune system). Much remains to be learned about the causes of these problems, but there is increasing evidence that moderate exercise can slow or prevent these effects.

For that reason, research projects have been set up on the John Walls Renal Unit to investigate the effect of exercise therapy on patients who have not yet started dialysis therapy, and also on patients who are treated with regular dialysis.

An instruction booklet for patients, explaining how to take regular and effective exercise safely has also been developed and can be down-loaded by clicking here.

The effects of 1 month or 6 months of walking exercise and, more recently, the effects of cycling exercise on fixed exercise bikes during dialysis are being investigated. The effects of this exercise on exercise tolerance, heart function and blood pressure are measured. Also blood samples are taken so that the functioning of the immune system can be studied, and small samples of muscle are removed from the legs of patients and from healthy volunteers so that the control of muscle growth can be studied too.

Photograph showing a sample of leg muscle being taken under local anaesthetic Photograph showing muscle samples being processed in a laboratory

Damage to the Heart & Kidneys Caused by High Cholesterol (The SHARP Study)

It has been known for many years that high blood cholesterol levels lead to damage to blood vessels and are an important cause of heart disease. However, similar processes also harm the blood vessels (the renal arteries) that supply blood to the kidneys. A large international study known as the Study of Heart and Renal Protection (SHARP) has been set up to discover whether drugs that can lower blood cholesterol can firstly reduce heart disease and secondly reduce damage to the renal arteries, and slow down the rate at which the kidneys fail in those patients who are already showing signs of kidney problems.

This study involves more than 9000 kidney patients and will run until 2010. It is the largest clinical research trial on kidney disease that has ever been undertaken. Sixty of these patients have been recruited at the John Walls Renal Unit – and this is one of the largest contributions from a single kidney unit in the UK.

More information on this study can be found at the Clinical Trials website

Research on New Ways to Prevent Kidney Damage Caused by Narrowing of the Renal Arteries (The ASTRAL Study)

In some patients damage to the kidneys occurs because the main blood vessels (the renal arteries) that supply blood to the kidneys become narrow and constricted, partly because of the build up of the cholesterol deposits that are being studied in the SHARP study above. The John Walls Renal Unit has been a major contributor to a multi-centre research study (known as the Angioplasty and Stent for Renal Artery Lesions or ASTRAL study) involving several kidney units across the UK. This has been testing the effectiveness of new mechanical methods for stretching the walls of the arteries to reverse this narrowing process.

Research supported byKidney Research UK Logo

More information on this study can be found at the ASTRAL Trial website

A diagnostic image showing a patient’s kidneys. The arteries supplying blood to the kidneys are shown by the red arrows. Diagnostic imaging of the same arteries in a patient with renal artery disease showing narrowing of the arteries supplying blood to the kidneys

Long-Term Research on Patients Who Have Received a Transplanted Kidney (The STEPP Study)

Image of the STEPP logo

Even though the first attempts to transplant human kidneys took place as long ago as the 1950’s, much remains to be learned about the long-term problems encountered by patients who have received a transplant.

For this reason, staff of the Transplant Surgery Group and the John Walls Renal Unit at Leicester General Hospital are leading a large collaborative study of these problems, involving five major UK transplant centres and 3000 patients. This research (known as the Study in Transplantation Empowering Patients and Practitioners or STEPP) is gathering information on the long-term functioning of the transplanted kidneys, the associated health problems that are experienced by the patients, and the patients’ own reported experiences of their health and quality of life. The ultimate aim is to use this information to improve the long-term survival of transplanted kidneys, and hence improve the duration and quality of life of the patients.

Kidney Research UK, in partnership with leading transplant companies, Astellas, Roche and Wyeth, and the British Transplantation Society (BTS) and the Renal Association, are supporting this study into long-term outcomes in renal transplantation.

More information on this study can be found at the STEPP website

Pregnancy in Women with Kidney Disease

Photograph of a pregnant lady

The medical problems experienced by women with kidney disease can become particularly complex during pregnancy. Until recently however there was no systematic mechanism for collecting information on this important group of patients. The John Walls Renal Unit was one of the first centres in the UK to set up a detailed database of all patients attending the local Kidney Antenatal Clinic.

This has now been expanded to a multi-centre UK Collaboration (known as UK CORD) whose aim is to study the outcome of kidney diseases in pregnancy. This will be the largest database of its type in the world, and a full-time Clinical Research Fellow has been appointed to work on this project.

UPDATED: 2nd June 2009
This document has been approved by the head of department or section.