A new approach to understanding the pathways involved in reducing infection risk in CKD patients

21 March 2025

Dr Joseph Sturman from the University of Birmingham has received a training fellowship of £275,000 to study the immune response to infectious diseases in patients with chronic kidney disease and find new ways to decrease their risk of severe infections.

The problem

Chronic kidney disease (CKD) impacts more than 7 million people in the UK and is predicted to become the fifth leading cause of death worldwide by 2040.

Patients with CKD are at increased risk of infections, but we do not fully understand why the immune system is less effective in these individuals. The risk is particularly well-known in a lung infection called tuberculosis (TB), and the team at Birmingham use TB as a model for understanding how the immune system’s response to infection is affected by CKD.

Initial findings have shown that, when removed from patients with CKD, immune cells can control TB infection just as well as immune cells from a person with normal kidney function. This suggests the ability of the immune cells to work properly is impacted by the environment of the patient’s blood in CKD and that damage to the immune system during CKD may be reversible. This is exciting as it means that patients’ risk of infection may also be reversible.

A male researcher, sat at a lab bench, wearing a white lab coat and blue glove, holding a pipette

Dr Joseph Sturman

The solution

To investigate this further, Joseph and the team will compare blood samples from patients with and without CKD to identify what may be causing the reduced immune response to infection.

The team will then see what impact these newly identified substances have on laboratory-based models of TB infection.

Finally, this grant will support the investigation of what currently available treatments may be able to target the identified molecules and improve the immune system function of patients living with CKD.

What could this mean for kidney patients?

This project could help us to better understand how the immune system is affected by CKD, allowing researchers to identify new ways to prevent infection in this at-risk group.

“I am particularly interested in infectious diseases, and how patients with CKD can overcome them. We know that the risk of infection is huge in this population and our research will help us to understand more about this. This means we can develop new treatments to help patients’ immune systems work better to fight infection”. Joseph Sturman.

Meet the researcher

Joseph Sturman is a Specialty Registrar in Nephrology and General Internal Medicine at University Hospitals Birmingham NHS Foundation Trust and Clinical Research Fellow at the University of Birmingham, currently undertaking a Kidney Research UK PhD Fellowship. His research focuses on the immune system and infectious diseases, particularly in relation to kidney disease.

In a report by Kidney Research UK, we show that healthcare inequalities due to age, sex, education, location or lack of wealth persist, despite widespread awareness of the barriers some people face.

Joseph says: “Undertaking this project in a diverse city such as Birmingham is an important opportunity to ensure this research helps to address the health inequalities that certain minority ethnic groups face particularly in healthcare and research, where they are often under-represented. By including ethnically diverse groups in this study, the results of the research will be more applicable to our local CKD population who we treat for infections every day.”