Immune responses to sodium minimisation in inflammatory kidney disease

  • Research type

    Research Study

  • Full title

    Prospective cohort study of immune responses to sodium minimisation through dietary salt restriction and diuretic administration in patients with native inflammatory kidney diseases and kidney transplant recipients: a pilot student-led project.

  • IRAS ID

    223362

  • Contact name

    Alan Salama

  • Contact email

    a.salama@ucl.ac.uk

  • Sponsor organisation

    University College London

  • Duration of Study in the UK

    2 years, 6 months, 7 days

  • Research summary

    Some forms of kidney disease result from problems with the immune system being overactive and causing damage. Over-activity of the immune system is also responsible for rejection of kidney transplants. When this occurs, there is imbalance in the immune system with more immune cells that cause inflammation and damage (called Th17 cells) compared to those that prevent inflammation and damage (called regulatory T cells).

    It has recently been shown that increased sodium (high salt) can affect the immune system, promoting increased Th17 cell activity and therefore more inflammation and disease. The kidney is the main place in the body where sodium levels are regulated but it is not known how changes in sodium balance affect the development of inflammatory kidney diseases, or if reductions salt may be used to influence the immune system.

    We want to investigate if reducing salt levels in patients with kidney disease and kidney transplant recipients can be used to promote a less inflammatory and more tolerant immune response. Moreover, we aim to understand the mechanism by which sodium affects immune cells.

    We plan to undertake a pilot human study at the UCL Centre for Nephrology. We will recruit patients with native kidney disease and kidney transplant recipients over a 3-year period. We will record baseline salt stores using a specialised sodium MRI scan and assess immune cell responses. Patients will then undergo salt depletion through dietary salt restriction or by the use of a diuretic (salt depleting) drug. We will repeat the analyses after the intervention to see if salt depletion can reduce salt stores and promote a more tolerant immune response, which may be beneficial in patients with a variety of different kidney diseases.

  • REC name

    London - Fulham Research Ethics Committee

  • REC reference

    18/LO/0214

  • Date of REC Opinion

    16 Mar 2018

  • REC opinion

    Further Information Favourable Opinion