Molecular Diagnosis In Renal Pathology Study
Research type
Research Study
Full title
Molecular Diagnosis In Renal Pathology Study
IRAS ID
288993
Contact name
Menna Clatworthy
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Chronic kidney disease (CKD) represents a significant and growing health burden, which affects up to 10% of the adult population in the United Kingdom. Curative therapeutic strategies are lacking and patients who progress to end stage renal disease (ESRD) require renal replacement therapy with either dialysis or kidney transplantation.
In approximately 17% of patients with ESRD, a clear cause cannot be identified, and in many other patients the primary diagnosis is inaccurate. Reaching a precise diagnosis is a vital step in ensuring patients receive appropriate treatment in a timely manner and to prognosticate on their long-term outcome. Furthermore, understanding the underlying pathogenic processes occurring during the development of CKD may help to identify novel therapeutic targets.
Renal transplantation has been the treatment of choice for many patients with ESRD for several decades, but only small improvements in long-term survival of the graft have been attained: damage to the transplanted kidney arises from attack by the recipient’s immune system (‘rejection’), infection, medication toxicity and recurrent primary disease. A lack of appropriate diagnostic tools to identify and accurately characterise damage to transplanted kidney is a major cause of this failure to increase graft longevity.The traditional approach for monitoring the transplanted kidney is to obtain a biopsy tissue sample for microscopic examination (‘histology’). However, this relatively rudimentary approach is hindered by significant interobserver disagreement and poor sensitivity. Consequently, histopathological diagnoses are of limited reproducibility and frequently fail to provide an accurate representation of pathological mechanisms. To remedy this, recent investigations have explored the possibility of using molecular technology (for example, genetic, proteomic and metabolomic analyses) to arrive at more objective and precise diagnoses.
The over-arching aim of this proposal is to develop molecular diagnostic tests for kidney disease which characterise patients more rigorously, and with greater confidence than is possible with existing approaches.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
22/SC/0088
Date of REC Opinion
19 Apr 2022
REC opinion
Further Information Favourable Opinion