The Kidney Fund has funded several Clinical Research Fellows, training promising young doctors in research disciplines and improving our understanding of renal pathology. Among our alumni are many of the current consultant nephrologists at Epsom & St. Helier University Hospitals NHS Trust. They include; Professor Hugh Gallagher a national expert in Chronic Kidney Disease; Dr Phanish Mysore a leading researcher of renal fibrosis and diabetic kidney disease, Dr Simon Winn, Dr Subash Somalanka, Dr Seema Jain and Dr Pritpal Virdee.
The Kidney Fund has helped build a centre of international excellence at The SWT Institute for Renal Research. Some of the notable projects supported by The Kidney Fund are briefly described below.
There are many factors that initiate chronic kidney disease but there is a common pathway that leads to kidney failure, fibrosis or scarring. The progressive development of scarring is a relentless process that eventually leads to complete organ failure.
The kidney fund has supported a series of projects that have helped demonstrate the role of Connective Tissue Growth Factor (CTGF) in renal fibrosis. The early work of Dr Phanish established how CTGF is made. Dr Winn continued this theme investigating how CTGF induces scarring. Further work supported by the Kidney Fund elucidated some of the subtleties in the actions of the CTGF family in the kidney. In 2021, in work co-funded by The Kidney Fund and Kidney Research UK at the SWT Institute for Renal Research, a method for blocking CTGF production in diabetic kidney disease lead to a recent landmark publication. More about CTGF in kidney fibrosis can be read on the SWT Institute for Renal Research web site.
For many years there was an aphorism in biology dating back to the 1940s, one gene = one protein. We now know that in complex organisms, like humans, a single gene may be able to make several proteins due to a process called “alternative RNA splicing”. Alternative RNA splicing has been implicated in many diseases, and the Kidney Fund has invested in an on-going programme of research investigating alternative RNA splicing in kidney disease. Starting from an investigation into the fundamental pathways regulating the early critical production of fibronectin in human kidney cells, work supported by the Kidney Fund elucidated pathways responsible for alternative splicing of fibronectin in a human cell culture model of fibrosis. Subsequent work supported by The Kidney Fund went on to complex interactions between alternatively spliced fibronectin and human kidney cells. The work attracted the attention of the pharmaceutical industry and led to a collaboration between The Fund and an industrial partner carrying out a pre-clinical trial of a novel anti-fibrotic strategy targeting alternative splicing of fibronectin.
You can read more about work supported by The Kidney Fund investigating the role of alternative RNA splicing in kidney fibrosis on the SWT Institute for Renal Research web site.
The early diagnosis of chronic kidney disease and the identification of the patients whose disease is likely to progress is a long-standing issue. It causes problems for the medical staff and can cheat patients out of the best available treatments. It has always been an important focus for The Kidney Fund. It started with The Fund’s support for work developing an accurate patient-friendly process developed at SWTIRR and further validated in collaborative work with the world famous Oxford Clinical Trials Unit.
The Kidney Fund also supported the early innovative work into a completely novel marker of progressive diabetic kidney disease. The Kidney Fund continued to support this work along with the UK Department of Health. Following the award of UK, European and Indian patents, we look forward to seeing a truly bench-to-bedside development supported by The Kidney Fund.
Patient based studies that are large enough to be statistically powered are often expensive to carry out. However, by working in partnership with Ortho Diagnostics the Kidney was able to support a study involving 400 patients with diabetes. Thanks to our close relationship with the Renal Unit at Epsom & St. Helier University Hospitals NHS Trust we were able to follow these patients for up to 5 years in the DUP-DN project based at the SWT Institute for Renal Research. The results of this study published in 2021 has identified a combination of biomarkers that will help to identify patients with diabetes who are developing diabetic kidney disease.
You can read more about work into improved diagnosis of kidney disease funded by The Kidney Fund on the SWT Institute for Renal Research web site.
Disease can often be a result of a disturbance in the balance of the body’s metabolism or other functions. An interesting approach is to try and identify where the imbalance has occurred and to try and rectify the imbalance. This is not a traditional strategy in disease treatment, but Kidney Fund has considered this idea and working with other organisations has funded projects using this approach. The Kidney Fund and The Genzyme Renal Innovations Programme co-funded a project based at The SWT Institute for Renal Research, but carried out in cooperation with The University of Utrecht in the Netherlands. This work was particularly productive in identifying how opposing factors in the kidney can induce disease when they are dysregulated, the cellular mechanisms that might cause kidney scarring and how the balance might be restored.
You can read more about projects supported by The Kidney Fund on restoring the natural balance in the kidney on the SWT Institute for Renal Research web site.
Kidney disease is a global problem, but the causes may vary in different parts of the world. The Kidney Fund is a UK charity and the work it funds is based in the UK, but that doesn’t mean we are deaf to the needs of others. Sri Lanka is a long way from the UK, but the two countries have had close relations for over 200 years. We share many values, including the belief in a health service available to all, but in recent years the Sri Lankan health service was at risk due to a new unexplained form of chronic kidney disease, called CKDu. Due to a series of coincidences The Kidney Fund found itself able to help by funding a project at The SWT Institute for Renal Research but largely carried out by a visiting Sri Lankan scientist, Dr Nalinda Silva from the University of Sri Jayewardenepura. Throughout the project Dr Silva gave his time without pay. Among the possible causes of CKDu was cadmium polution, but with no treatment for cadmium induced kidney damage this was not a welcome possibility. In The Kidney Fund financed project at SWTIRR, some novel possible treatments were investigated. The results of the study identified an inexpensive treatment that could block cadmium induced damage of human kidney cells. The work was presented in an international meeting in Paris by Dr Silva and published the following year.