Summary of 13th Round BRS Grant Awards (2013)
These grants have been awarded by the BRS working in collaboration with the British Kidney Patient Association
Recipient
Hospital
Title of Grant Project
Brief Description of the Project
Amount of
Award
Chronic kidney disease (CKD) is associated with a myriad of co-morbidities and
characterised by physical and psychosocial reductions in functional ability, including
fatigue, muscle wasting, reduced physical functioning, malnutrition, and depression,
particularly during the transition to dialysis. This in turn leads to an overall decline in
functional capacity, ability to perform routine activities of daily living (ADL), and
rapidly increasing levels of dependency on others.
The aim of this research project is to determine the clinical effectiveness of a
programme of pre-emptive multidisciplinary rehabilitation in patients approaching
dialysis, and whether it more successfully reduces the decline in functional capacity
and quality of life (QOL) associated with commencing dialysis, in comparison to
standard care. A recent pilot study within Derby Hospitals NHS Trust demonstrated
the feasibility of proactive delivery of a patient-centred programme of pre-emptive
multidisciplinary rehabilitation in patients approaching dialysis
Analysis of the study results will determine whether pre-emptive rehabilitation is
more beneficial upon functional independence and QOL than standard pre-dialysis
and dialysis care, and will help determine optimal patient care and influence future
guidelines.
University Hospitals Coventry and Warwickshire (UHCW) NHS Trust have agreed
that cholecalciferol should be introduced into the standard care of haemodialysis
patients. This change to routine care allows an opportunity to collect data in order
to test for the effects of vitamin D repletion on EPO requirements and markers of
iron metabolism. The proposed research has been designed alongside the planned
change in routine care.
The Research Question: Does routine cholecalciferol supplementation reduce EPO
requirements?
The Research aims:
 To assess whether increased serum 25(OH)D levels result in an improved
response to EPO, measured by a reduction in mean EPO dose.
 To assess whether improved serum 25(OH)D levels aid erythropoiesis
£22,000.00
Ms Fiona
Willingham
Royal Derby
Hospital
Pre-emptive
rehabilitation to prevent
dialysis-associated
morbidity (PREHAB)
Miss Sharon
Parker
University
Hospital,
Coventry
Evaluating the impact
of routine
cholecalciferol on
Erythropoietin (EPO)
requirements
£17,500.00
Dr Adnan
Sharif
Queen Elizabeth
Hospital
Birmingham
A randomised
controlled trial
comparing glycaemic
benefits of active
versus passive lifestyle
intervention in kidney
allograft recipients
Dr Annie
Mitchell
University of
Plymouth
Understanding barriers
and enablers to
altruistic kidney
donation in a social
group context
through greater iron availability, measured by a reduction in serum hepcidin
levels.
New-onset diabetes after transplantation (NODAT) is a common medical
complication after kidney transplantation, related to both transplant-specific and
generic risk factors1, and is associated with major complications after
transplantation2. Existing NODAT Consensus guidelines3 recommend lifestyle
modification (e.g. weight loss, dietary modification, structured exercise program) as
the first line therapy of choice, no recommendation is given with regards to how
such guidance should be delivered. In addition no clinical evidence exists to
suggest lifestyle modification provides any sustained glycaemic benefits for kidney
allograft recipients. While in the general population the benefits of lifestyle
modification have been well documented with regards to attenuation of both prediabetic and diabetic states in the context of randomised controlled trials4-6, no
similar level of evidence exists post kidney transplantation.
The aim of this research project is to compare the glycaemic benefits of active
versus passive lifestyle modification in kidney allograft recipients who are high-risk
for NODAT. This will be one of the few randomised controlled trials in the context of
NODAT prevention and management, and the only randomised controlled trial to
assess the benefit of lifestyle modification in kidney allograft recipients.
Altruistic kidney donation (AD) where the donor donates to a unknown recipient
was introduced in the UK in 2006. The number of subsequent donations has
exceeded clinical prediction, with AD now accounting for around 10% of all living
donations. A YouGov poll conducted in 2011 indicated that 8% of the UK population
would consider donating a kidney through the AD scheme (Thornhill, 2011). This
interest is not, however, currently translating into donations and the related reasons
are unclear.
Research into the experience of UK based Altruistic Donors (ADs) has indicated
that there are key stages in the donation process that are experienced as difficult
and have the potential to cause the donor to reconsider (Clarke, Mitchell and
Abraham, 2013). One of the most prolific AD transplantation centres, Portsmouth
Hospital Trust, has reported that around 35% of prospective donors who contact
the centre, withdraw from the process (Chester et al., 2013). Lack of social support
has been identified as a having a role in around half of those who withdraw
(Chester et al., 2013). There is not, however, a good understanding of what is
meant by lack of social support, what other reasons may have led potential donors
to withdraw and what role services could have in supporting potential ADs and thus
enabling donation. This study aims to answer those questions.
The results from this study would be important in helping to shape the future
development of renal services, by informing policy and practice. They would directly
lead to development of resources tailored to the needs of prospective ADs and their
significant others.
Total of Grants Awarded
£18,000.00
£28,990.00
£86,490.00