BRS is recognised as a partner organisation of the NIHR
Improved patient care - our ultimate aim
Research for Renal Team 2008 - 2011
Fifty years ago, severe kidney failure was almost invariably fatal. There are now effective treatments such as dialysis and transplantation that currently allow over 40,000 UK patients to continue living with severe kidney failure. This number is expected to double over the next 10 years. The replacement of kidney function can therefore no longer be thought of as a rarity.
The impact of chronic kidney disease on the body is much wider than most people realise. As well as progressing in severity to eventually require dialysis or transplantation, it causes high blood pressure, anaemia and bone disease even in its relatively early stages. These are all amenable to treatment if recognised.
It is now well recognised that less severe chronic kidney disease is very common, particularly in the elderly. Around 5% of the population have kidney function less than 60 percent of normal. In some of these the kidney failure is progressive. In many it is not. Even when kidney failure does not progress, patients are at greater risk, mainly due to the increased frequency of cardiovascular events. Early identification and treatment to retard progression and reduce cardiovascular risk would be of great potential benefit.
Even though we now have effective treatments for severe kidney failure, major problems remain. The survival of patients on dialysis, and to a lesser extent transplantation, is markedly reduced compared to those without kidney failure. In particular patients with kidney disease are very susceptible to cardiovascular disease for reasons that are only partly understood. There are also problems with the treatment processes themselves. Dialysis is invasive, time-consuming, expensive, and can be debilitating. Transplantation requires life-long suppression of the immune system; it is limited in availability and in some people is less viable than remaining on dialysis. The delivery of these complex treatments requires the coordinated input of health professionals from many disciplines including physicians, surgeons, nurses, dietitians, technicians, pharmacists, managers, social workers, and industry. The effective planning of service provision with commissioners is also central to the delivery of such care in an equitable and timely fashion. There is much to be done and much to be learned in all these areas, if we are to improve the patient experience