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£1.9million funding to help improve diagnosis and treatment of kidney disease

MRI scanning machine

New research will look at how novel methods of kidney MRI scanning can help improve diagnosis and treatment for people living with kidney disease, thanks to a £1.9 million grant from the Efficacy and Mechanism Evaluation (EME) Programme – a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership.

Researchers from University Hospitals of Derby and Burton NHS Foundation Trust and the University of Nottingham, will use multiparametric MRI scanning to assess patients suffering with long-term reductions in kidney function, known as Chronic Kidney Disease (CKD).

The study, called ‘AFiRM’, will be led by Dr Nick Selby and Professor Maarten Taal from the Centre for Kidney Research and Innovation (CKRI), and Professor Sue Francis from the Sir Peter Mansfield Imaging Centre (SPMIC) at the University of Nottingham.

Professor Maarten Taal (left), and Dr Nick Selby (right)

Professor Maarten Taal (left), and Dr Nick Selby (right)

Multiparametric MRI scanning incorporates several different MRI techniques into a single scanning session. This allows assessment of processes that influence or cause kidney disease, such as changes in blood flow, oxygen levels and the degree of scarring (fibrosis). Unlike X-rays and CT scans, MRI scans do not use radiation and patients do not need dye injections, making it completely safe for patients to be scanned on multiple occasions.

The AFiRM study has three stages, with the first stage testing the scanning technique on a small number of patients to demonstrate that it is working well and that the process is acceptable. In the second stage, 450 patients with CKD will be invited to have multiparametric MRI scans of their kidneys, which will be repeated after two years. Their progress will then be followed and their kidney function assessed with annual check-ups.

The third aspect of the research study will focus on a smaller group of patients who take part in the research but who have also had a kidney biopsy as part of their usual care. A biopsy is currently the only way to directly see disease processes inside a patient’s kidneys. Analyses to compare MRI results against kidney biopsy will be performed to provide additional, more detailed evidence as to how multiparametric MRI can be used to visualise different disease processes that lead to CKD.

Dr Nick Selby, Honorary Consultant Nephrologist at University Hospitals of Derby and Burton NHS Foundation Trust and Associate Professor of Nephrology at the University of Nottingham, said: “At the moment, most people with kidney disease have only a basic ultrasound scan that provides only a small amount of information about the structure of the kidneys, and no information on their function or the type of disease affecting them.”

“This research study is extremely exciting because it will show us how advanced MRI scanning techniques can be used to give us more information about the nature of kidney disease that individuals are experiencing. Ultimately, we hope that this will improve how we plan and monitor treatments.”

Professor Danny McAuley, Director of the NIHR Efficacy and Mechanism Evaluation (EME) Programme, said: “This is a very important area of research. Advanced scanning techniques provide an area of great potential in assessing and diagnosing kidney disease with less risks for patients. This could offer real benefits for clinical care and long-term health of patients with kidney disease.”

AFiRM has been developed in collaboration with a national research group, the UK Renal Imaging Network (UKRIN), and is taking advantage of work funded by the Medical Research Council (MRC) to ensure that MRI scanners at all major UK research centres can perform multiparametric MRI for the kidneys in a standardised way, ensuring comparable results (UKRIN-MAPs).

The study will be managed by the team at Derby Clinical Trials Support Unit at the Royal Derby Hospital, and take place in eight UK centres in addition to Derby and Nottingham (full list below).

The study will begin in September 2020 and run for seven years.

Follow Centre for Kidney Research and Innovation on Twitter: @CKRIresearch      

 

Participating centres:

Derby-Nottingham, Edinburgh, Glasgow, Newcastle, Leeds, Sheffield, Manchester-Salford, Cambridge, London (UCL).

 

Supported by:

UK Renal Imaging Network, UK Renal Registry, Human Biomaterials Resource Centre (University of Birmingham), Derby Clinical Trials Support Unit (@DerbyCTSU)

 

Notes

MRC and NIHR

The study was funded by an MRC and NIHR partnership created to support the evaluation of interventions with potential to make a step-change in the promotion of health, treatment of disease and improvement of rehabilitation or long-term care.

1. The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

  • Funds, supports and delivers high quality research that benefits the NHS, public health and social care
  • Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
  • Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
  • Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
  • Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.

2. The Medical Research Council is at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Thirty-three MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms. The Medical Research Council is part of UK Research and Innovation. https://mrc.ukri.org/

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. www.nihr.ac.uk/patientdata

 

University of Nottingham

The University of Nottingham is a research-intensive university with a proud heritage, consistently ranked among the world's top 100. Studying at the University of Nottingham is a life-changing experience and we pride ourselves on unlocking the potential of our 44,000 students - Nottingham was named both Sports and International University of the Year in the 2019 Times and Sunday Times Good University Guide, was awarded gold in the TEF 2017 and features in the top 20 of all three major UK rankings. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement. We are ranked eighth for research power in the UK according to REF 2014. We have six beacons of research excellence helping to transform lives and change the world; we are also a major employer and industry partner - locally and globally.”