Our work
Chronic kidney disease progresses faster in hot countries
Chronic kidney disease patients living in the hottest countries experienced an additional 8% drop in kidney function each year compared to those living in temperate climates, finds a new study.
Clinical Glomerular Group
We provide specialist care for patients with lupus, vasculitis, nephrotic syndrome, IgA nephropathy and IgG4 disease.
We are actively involved in several ongoing national and international clinical trials investigating different treatment regimes in glomerular disease. Patients with vasculitis are recruited into a national reporting registry (UKIVAS).
We are at the forefront of translation research and have published extensively in this area investigating underlying immune processes important in the pathogenesis of disease.
Principal Investigators
- Professor Alan Salama
- Professor Aine Burns
- Dr John Connolly
- Dr Sally Hamour
- Dr Ruth Pepper
Clinical Trials in Chronic Kidney Disease
People with chronic kidney disease have a shortened life expectancy, despite treatment with dialysis and kidney transplantation. Early therapeutic interventions that slow progression of chronic kidney disease (CKD) and reduce the impact of its complications should improve outcomes for these individuals.
My research is focussed on the evaluation of new therapies for CKD patients through the conduct of randomised controlled trials. I have been involved in the academic leadership of several trials assessing therapies including statins, calcimimetics, hypoxia-inducible factor (HIF) stabilizers, intravenous iron and sodium glucose co-transporter 2 (SGLT2) inhibitors.
Principal Investigator
- Professor David C Wheeler
Causes, progression and complications of CKD
Ben Caplin’s team aims to understand further the causes and consequences of chronic kidney disease (CKD). The group has a particular focus on endemic nephropathies in low- and middle-income countries (LMICs). Our current work includes the following.
Globally, most CKD occurs in the elderly, and in those with diabetes and cardiovascular disease but there is now increasing recognition of forms of progressive kidney injury which are not due to known causes, with devastating effects on the working-age populations of Central America and South Asia. The common clinical features of this syndrome - termed CKD of undetermined cause (CKDu) - are impaired kidney function in the absence of diabetes, atherosclerotic vascular disease, evidence of primary glomerulonephritis or structural abnormality.
In collaboration with the team at the National Autonomous University of Nicaragua, Leon (UNAN-Leon), we lead a longitudinal cohort study which has recruited the (initially) unaffected young adult population of eleven communities at-risk of CKDu in Northwest Nicaragua (where the condition is termed Mesoamerican Nephropathy). The study has reported loss of kidney function which is without parallel at a population level with almost one-in-ten young men losing over 15% of kidney function (from a normal baseline) per year. The fact that women were also affected but at lower rates suggests there may be a key occupational element to disease. This work aims not only to describe the natural history and risk factors for disease but also provide a unique biobank of samples captured contemporaneously with the earliest signs of kidney decline in those affected. We are exploring several genetic and other ‘omic’ approaches in these samples, in parallel with in vitro mechanistic studies to gain insight into disease aetiology (in collaboration with Prof. Jill Norman).
Alongside Prof. Neil Pearce at London School of Hygiene and Tropical Medicine, we have been instrumental in establishing international collaborative efforts to describe the burden of CKDu around the world (the DEGREE collaboration). Robust estimates of the prevalence of CKDu are not only important for local health service planning, they also provide the basis for assessment of secular trends and international comparisons, which may in turn provide insight into aetiology.
Ben Caplin has designed and contributes to ongoing studies on UK-based CKD. The East and North London Diabetes Cohort Study (HEROIC)Alongside the team at Barts Health (Professor Magdi Yaqoob and Doctor Kieran McCafferty) we have conceived and designed HEROIC, an observational cohort study of those with biopsy proven diabetic kidney disease. The study, now recruiting, employs cutting-edge imaging techniques as well as collecting a range of biological samples with plans to exploit (epi)genomic, metabolomic and proteomic technologies to better understand the heterogeneity of disease and gain insight into key mechanistic pathways in the disease evolution and associated complications. Electronic health records to better understand the consequences of CKD in the UK. Working with the team led by Professor Dorothea Nitsch at London School of Hygiene and Tropical Medicine and Professor David Wheeler at UCL, Ben Caplin co-led the analytical team delivering the Health Quality Improvement Partnership National CKD Audit in Primary Care. Although the audit is now closed, we continue to aim to use electronic health records to gain insight into the identification of those with disease as well as access, processes, variability, and outcomes of care in those with CKD.
The team have a long-standing interest in the cardiovascular complications of CKD. In addition to athero-occlusive disease that is seen in much of the population those with CKD exhibit stiff arteries with reduced wall elasticity containing abnormal smooth muscle cells and altered extracellular matrix. The mechanisms underlying the arterial changes in CKD-associated CVD remain elusive. Recently, in collaboration with Prof. Stephan Beck and taking advantage of arterial material donated by transplant patients, we have examined the contribution of DNA-methylation in the cells of the arterial in the evolution of these changes.
Principal Investigator
- Ben Caplin
Group members
- Marvin Gonzalez-Quiroz
- Eva Smpokou
- Viyaasan Mahalingasivam
CKD: Conservative management and end of life care
The Royal Free NHS Trust was one of the first units in the country to introduce a formal conservative care programme as an alternative to dialysis for patients who chose not to dialyse often because of old age and high co-morbidity. The multidisciplinary group has an active clinical research programme in this area and has contributed to both national and international recommendations surrounding end of life care. Much of the research is conducted in collaboration with the Marie Curie Care Centre at UCL.
Principal Investigator
- Professor Aine Burns
Metabolic stone disease
Shabbir trained in Edinburgh and Newcastle upon Tyne and has a special interest in renal physiology particularly regarding renal stone formation. His PhD research investigated pyrophosphate transport physiology in the kidney. He runs the Metabolic Renal Stone clinical service at the Royal Free and is principal investigator and chief investigator for interventional trials in hyperoxaluria. He has an interest in rare renal diseases as part of the RADAR (National Renal Rare Disease Registry) network and is chair of the groups for hyperoxaluria and APRT deficiency. He was the nephrologist member of the NICE Guidelines Committee for renal stones, and is currently on the Quality Standards Advisory Committee for renal stones.
Principal Investigator
- Dr Shabbir Moochhala
Dialysis (haemodiafiltration / haemodialysis / peritoneal dialysis)
Our projects range from assessing the relationship between body composition, energy expenditure and dialysis dosing for both peritoneal and haemodialysis patients, to the investigation of and role of sodium balance and volume status during haemodialysis and changes in blood pressure, and divalent ion balance during haemodialysis and haemodiafiltration, and similar studies in peritoneal dialysis.
We also have a further series of studies designed to investigate the potential role of newer surrogates for dialysis adequacy and cardiovascular biomarkers and risk factors in both haemodialysis and peritoneal dialysis patients.
The UCL Dialysis & Physiology Centre is one of the partners in the European Horizon 2020 funded CONVINCE Trial comparing high volume on-line haemodialfiltration with high flux haemodialysis. We are also the lead centre for the STITCHED mechanistic study nested within the UK H4RT study, again comparing high volume on-line haemodialfiltration with high flux haemodialysis.
Lead investigators
- Dr Jenny Cross
- Professor Andrew Davenport
National Amyloidosis Centre
Professor Julian Gillmore undertook MD and PhD degrees in the field of amyloidosis. His research interests include pathogenesis, diagnosis, and treatment of amyloidosis. He was appointed Centre Head at UCL's Centre for Amyloidosis & Acute Phase Proteins in 2019 and is research lead at the UK National Amyloidosis Centre.
He has published more than 250 peer-reviewed articles, has supervised students through their post-doctoral research degrees, is CI/PI on a range of amyloid-related clinical trials, and has received extensive grant funding.
Principal Investigator
- Professor Julian Gillmore
National Amyloidosis Centre
The NHS National Amyloidosis Centre offers diagnosis, staging, monitoring, and management advice for amyloidosis patients. We conduct with clinics via phone, video, or in person.
Our People
Head of Unit
Deputy Head
Director of Postgraduate Medical Education
Professor of Nephrology
Associate Professor
John Connolly
Honorary Associate Professors
Professor of Nephrology
Divisional Clinical Director
UCL Partners
Consultant Nephrologist
Kin Yee Shiu
Consultant Nephrologist in Nephrology
Robin Woolfson
Clinical Kidney Disease and Dialysis
Celebrating research at the Royal Free London
Professor David Wheeler has been named in the internationally recognised annual Clarivate listings of the ‘world’s most influential researchers.
Selected Publications
- RECOVERY Collaborative Group (inc. Ben Caplin et al.) (2022). Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet, 399 (10320), 143-151.
- Cleary F, Kim L, Wheeler D et al. (2022). Association between practice coding of chronic kidney disease (CKD) in primary care and subsequent hospitalisations and death: a cohort analysis using national audit data. BMJ Open, 12 (10).
- RECOVERY Collaborative Group (inc. Ben Caplin et al.) (2022). Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis. The Lancet, 400 (10349), 359-368.
- RECOVERY Collaborative Group (inc. Ben Caplin et al.) (2022). Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. The Lancet, 399 (10325), 665-676.
- O'Callaghan-Gordo C, Arjona L, Caplin B et al. (2022). Heat stress and incidence of acute kidney injury among agricultural workers in Spain.
- Ashby DR, Caplin B, Corbett RW et al. (2022). Outcome and effect of vaccination in SARS-CoV-2 Omicron infection in hemodialysis patients: a cohort study. Nephrology Dialysis Transplantation.
- Ashby DR, Caplin B, Corbett RW et al. (2022). Severity of COVID-19 after Vaccination among Hemodialysis Patients: An Observational Cohort Study. Clin J Am Soc Nephrol.
- RECOVERY Collaborative Group (inc. Ben Caplin et al.) (2021). Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. The Lancet, 397 (10274), 605-612.
- Ruiz-Alejos A, Caplin B, Miranda JJ, Pearce N, Bernabé-Ortiz A. (2021). CKD and CKDu in northern Peru: a cross-sectional analysis under the DEGREE protocol. BMC Nephrology, 22 (1), doi:10.1186/s12882-021-02239-8 (2021).
- Dritsoula A, Ponticos M, Caplin B, Wheeler DC et al. (2021). Epigenome-wide methylation profile of chronic kidney disease-derived arterial DNA uncovers novel pathways in disease-associated cardiovascular pathology. Epigenetics, 1-11.
- Hendra H, Vajgel G, Ben Caplin et al. (2021). Identifying prognostic risk factors for poor outcome following COVID-19 disease among in-centre haemodialysis patients: role of inflammation and frailty. Journal of Nephrology.
- Caplin B, Ashby D, McCafferty et al (2021). Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients. Clinical Journal of the American Society of Nephrology.
- RECOVERY Collaborative Group (2021). Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. The Lancet, 397 (10285), 1637-1645.
- Heerspink HJL, Stefansson BV, Wheeler DC et al. for the DAPA-CKD Trial Committees and Investigators. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2020 Oct 8;383(15):1436-1446.
- Perkovic V, Jardine MJ, Wheeler DC et al; CREDENCE Trial Investigators. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med. 2019; 380(24):2295-2306.
- Macdougall IC, White C, Wheeler DC et al; PIVOTAL Investigators and Committees. Intravenous Iron in Patients Undergoing Maintenance Hemodialysis. N Engl J Med. 2018;380(5):447-458.
- Cohen O, Rendas-Baum R, McCausland K et al. (2023). Linking changes in quality of life to haematologic response and survival in systemic immunoglobulin light-chain amyloidosis. British Journal of Haematology.
- Vergaro G, Castiglione V, Aimo A, Prontera C, Masotti S, Musetti V ... Georgiopoulos G (2023). NT-proBNP and High-Sensitivity Troponin T Hold Diagnostic Value in Cardiac Amyloidosis. European Journal of Heart Failure.
- Porcari A, Razvi Y, Masi A, Patel R, Ioannou A, Rauf MU ... Martinez-Naharro A (2023). Prevalence, Characteristics and Outcomes of Older Patients with Hereditary versus Wild-Type Transthyretin Amyloid Cardiomyopathy. European Journal of Heart Failure.
Funding and Partnerships
Medicine MPhil/PhD
A full or part-time research degree at the UCL Division of Medicine offers broad research training opportunities under the supervision of academics who are world experts in their fields.
Renal Short Courses
These are short courses run over three or four days and each covers a wide breadth, ranging from the patient pathway to therapies to cutting edge science.
Postal / Visiting Address
UCL Department of Renal Medicine (formerly Centre for Nephrology)
UCL Medical School
Rowland Hill Street
London NW3 2PF
