Renal Medicine

Dr Andrew Lewington

Associate Clinical Director and Renal Theme Lead

Dr Sunil Daga

Renal Medicine Deputy Lead

Renal Medicine

Addressing urgent need to improve diagnostics and therapeutic interventions for renal patients

Renal patients often require treatment and monitoring throughout their lives and better diagnostics have the ability to drastically improve their standard of living. The NIHR Leeds MIC Renal Team specialises in in vitro diagnostic (IVD) development for acute kidney injury (AKI), chronic kidney disease (CKD) and kidney transplantation.

Acute Kidney Injury

AKI is a syndrome with many different causes. In the majority of cases it is secondary to sepsis, toxins or low blood pressure in acutely ill patients. It is a common condition occurring in up to 18% of hospital patients and can result in increased hospital length of stay, mortality and the development of CKD in 40% of AKI survivors. The annual cost of AKI to the NHS in England is estimated to be just over £1 billion. 

Chronic Kidney Disease

CKD is a long-term condition where the kidneys do not work as well as they should. It affects around 10% of the world population. It is associated with increased cardiovascular risk and can progress to end stage kidney disease (ESKD) requiring dialysis or kidney transplantation. CKD in the UK is estimated to cost the NHS £1.45 billion a year. Current therapies are restricted in clinical practice by limitations in the underlying pathophysiology. Biomarker-based IVDs are urgently needed to improve earlier identification and stratification of patients with progressive CKD to drive the development of treatments.

Kidney Transplantation

Kidney transplantation is the most common treatment of choice for patients who have developed ESKD following AKI or progressive CKD. There is a chronic shortage of donor kidneys, and patients awaiting kidney transplantation have an increased risk of death. The function of a kidney transplant is monitored closely through the recipient’s lifespan. Current IVD tests are limited in their scope and do not differentiate the causes of acute kidney transplant injury, nor identify patients at risk of progressive chronic kidney transplant disease. There is therefore a need to develop new IVDs to guide and optimise the management of patients with kidney transplants.