About the AFiRM Study

AFiRM is a multicentre cohort study that will use multiparametric MRI to assess different aspects of kidney structure and function in 450 people with Chronic Kidney Disease (CKD).

Participants will have renal MRI performed at study entry and again after 2 years. Renal function and albuminuria will be collected at annual follow up visits, and biosamples (plasma, serum, urine and DNA) collected at baseline. Long term follow up data will be collected for 10 years via the UK Renal Registry.

Nine centres are taking part: Nottingham-Derby; Glasgow; Edinburgh; Newcastle; Sheffield; Leeds; Salford-Manchester; Oxford; and Cambridge. These centres are part of the UK Renal Imaging Network (opens in new window) > (UKRIN), and the AFiRM study will build on work already in progress within a Medical Research Council funded project called UKRIN-MAPS (opens in new window) >. UKRIN-MAPS will standardise the way multiparametric MRI scans are performed across different MRI scanners and sites.

AFIRM starts in September 2020 and will continue for 7 years.

The study has three stages to address the following objectives:

  1. To establish a multiparametric renal MRI protocol in CKD cohorts.
  2. To use multiparametric MRI to characterise people with and without CKD progression.
  3. To compare multiparametric renal MRI with ‘gold-standard’ renal biopsy to determine pathological processes of CKD progression that are detectable by MRI.

Anticipated impact and dissemination

This study will build on UK investments in renal MRI to generate reliable data that will advance the translation of renal MRI to clinical practice. Outputs will underpin improvements in patient care, substantially broaden research activity and lay foundations for industry collaborations. Multiparametric renal MRI has the potential to transform the development of novel drugs to reduce CKD progression by providing a new means for patient selection (identification of people with mechanisms of CKD progression that are appropriate to the drug being tested) and new measures to detect response to therapy earlier than traditional clinical outcome measures. Dissemination will target a range of stakeholders including clinicians, academic groups, industry, patients and the public to maximise impact of the research.

The study has three stages:

Stage 1

June 2021 – February 2022

An internal pilot study to demonstrate feasibility of performing the MRIs at each of the centres (5 participants per site).

Stage 2

February 2022 - November 2028

Following successful completion of Stage 1, the study will recruit a total of 500 participants across ten centres in the UK.

Stage 3

Biopsy sub-study

In Stage 2, a minimum of 45 participants will have renal biopsy samples analysed using quantitative immunohistochemistry that will be compared against MRI measures.

multiparametric MRI

Image above shows example images from Multi Parametric Renal MRI.