Kidney Disease and Diabetes
More than half a million people worldwide have a kidney transplant and many more are waiting for one. People with kidney disease have a much higher risk of developing a number of diseases, particularly cardiovascular disease. In Diabetes Mellitus blood sugar levels are raised over a prolonged period. People with diabetes are at increased risk of cardiovascular disease, kidney disease and damage to the eyes. Rates of type-2 diabetes have increased rapidly in recent decades due to changes in diet and other lifestyle factors.
Our main contribution to understanding the causes and treatment of chronic kidney disease to date is the Study of Heart and Renal Protection (SHARP). With about 9,400 patients in 400 hospitals in 18 countries, this is the largest randomised trial yet involving patients with chronic kidney disease. The results showed that lowering these patients' blood cholesterol reduced their risk of heart attacks and strokes, and has resulted in the widespread use of statin-based treatment in people with chronic kidney disease worldwide.
A research priority is to better understand how to extend the life of transplanted kidneys. People who receive a kidney transplant need drugs to prevent their body from rejecting the new kidney but standard medications to prevent rejection may also cause long-term damage to the kidney. We are coordinating the Campath, Calcineurin inhibitor reduction and Chronic allograft nephropathy (3C) trial which recruited 850 patients at the time of their kidney transplant. The 3C trial is testing two new treatments which might avoid this long-term damage and is being run by a UK-based collaboration of transplant units.
The UK-HARP-III trial, is a pilot study to assess the effects of a new drug (LCZ-696) on the progression of kidney disease as compared to standard treatment (irbesartan). 414 patients were recruited to the trial in March 2016.
With over 15,000 participants our ASCEND trial was one of the largest randomised trials to investigate whether aspirin and omega-3 fatty acids are effective in preventing cardiovascular disease in people with diabetes. Large cohorts, including the China Kadoorie Biobank (CKB), UK Biobank and the Mexico study in which participants have provided blood samples, will provide new insights into the causes of diabetes, which will lead to better ways to prevent and treat the condition.