Dialysis and Physiology

Lead investigators: Dr Jenny Cross, Professor Andrew Davenport

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: Professor Andrew Davenport, Dr Chris Laing

The Royal Free Hospital is the central hub of the North London Acute Kidney Injury Network. We are currently involved in several clinical projects including biomarker studies in decompensated cirrhosis and post-cardiac surgery and epidemiological and clinical studies in management of patients with AKI and developing novel treatments for patients with acute on chronic liver failure with acute kidney injury.

Lead investigators: Dr Shabbir Moochhala, Professor Robert Unwin

We are interested in finding new ways to treat kidney stone disease as the more common forms are becoming increasingly problematic in the UK and worldwide. We are participating in clinical trials into pharmacological treatment for certain calcium stone formers. Some families have a very strong family history of stone formation, and we are looking for genetic causes in these families or using our large DNA biobank to look for patterns in larger groups (collaborations with Renal Genetics group).

We recognise that collecting urine over 24 hours is inconvenient for patients, so we are now trialling new portable infra-red technology to obtain biochemical data quickly and accurately for urine and stones in collaboration with UCL Structural and Molecular Biology.

Lead investigators: Dr Joanne Marks, Professor Robert Unwin

Glucose transport across renal and intestinal cells contributes to body glucose balance and is markedly altered in diabetes mellitus (DM). We aim to elucidate the mechanisms leading to altered intestinal and renal glucose transport in DM. DM accounts for almost 30% of patients developing advanced CKD, so defining the role of altered glucose transport in DM and the relationship to its major renal complication is likely to be important.

The intestine and kidneys are also involved in the regulation of body phosphate balance, which has been linked to premature CVD and vascular calcification in CKD. Phosphate overload occurs in CKD. In the absence of adequate excretion by the kidneys to prevent this, absorption by the intestine becomes an important therapeutic target.

We are investigating the mechanisms of phosphate absorption by the intestine and how they are regulated, particularly by a group of novel hormones called phosphatonins. One in particular, FGF-23, has also been implicated in vascular calcification.