Renal & Urogenital - Current Research

Renal & Urogenital research taking place at North Bristol NHS Trust

North Bristol NHS Trust is a centre of excellence for the delivery of care for people with renal impairment. Our experienced research team works collaboratively with a number of other research teams including diabetes and cancer to deliver cross-functional complex studies in addition to studies focused solely within the renal service.

Current studies:

H4RT

End-stage kidney disease (ESKD) affects ~55,000 people in the UK, with ~7,000 newly affected people each year. It ranks among the most severe of the chronic non-communicable diseases. Morbidity is high, with dialysis patients in the UK admitted to hospital on average ~1.5-2.0 times per year and spending ~15 days in hospital per year. Quality of life on dialysis is also well below that of the general population. There is therefore an unmet and urgent need to improve ESKD patient treatment.

Renal replacement therapy (dialysis or transplantation) is necessary when patients become symptomatic of ESKD. Currently ~90% of dialysis patients are on some form of haemodialysis (HD) or haemodiafiltration (HDF). Although HD and HDF can be performed at home, the majority is performed in-centre.

Treating the 25,000 people on HD costs around £500m of NHS spending each year, with a further £75m spent on hospital admissions and £50m on transport to and from dialysis. Half of patients now starting dialysis are 65 years or older and less likely to be fit for kidney transplantation and in the general population this group is predicted to increase by 60% (from 10.3m to 16.9m) by 2035. While preventing ESKD in the first place should remain a priority, the optimal form of dialysis will remain highly relevant to the NHS.

This study aims to establish the effectiveness and cost-effectiveness of high-volume HDF compared with high-flux HD in adult patients with ESKD on maintenance thrice weekly in-centre HD. We will do this by running a randomised controlled trial using non-cancer mortality or hospital admission due a cardiovascular event or infection as our primary outcome.

Host Site: North Bristol NHS Trust

Chief Investigator: Dr Fergus Caskey

End Date: 31/03/2024

RCT PrepareME for Kidney Care

When kidney function drops to 15% of normal, symptoms such as tiredness, loss of appetite and sickness usually develop. At this stage, dialysis or kidney transplantation is considered. Dialysis involves visiting the hospital for 4 hours of treatment 3 times a week, or flushing fluid in and out of your system through your abdomen 4 times a day every day at home.  There is evidence that some older people with many medical problems (co-morbidities) do just as well with conservative care (home visits) as dialysis (hospital visits), but more evidence is needed to help patients and their families make the best decision.

The PrepareME Trial aims to provide far better evidence to help patients and their families reach the best decision for them and influence NHS policy on care for this group of patients.

Host Site: North Bristol NHS Trust

Chief Investigator: Dr Fergus Caskey

End Date: 31/12/2023

Contact Research & Innovation

Research & Innovation
North Bristol NHS Trust
Floor 3, Learning & Research Centre
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

H4RT Study Website

H4RT Study Website

This site details all the sites involved in this study and on-going updates on the progress of the trial.

Prepare for Kidney Care

Prepare for Kidney Care Study Website

This site details all the sites involved in this study and on-going updates on the progress of the trial.