New results from NURTuRE highlight importance of individualised care in chronic kidney disease
A new paper published in the American Journal of Nephrology by Dr Thomas McDonnell used NURTuRE to investigate how underlying causes of chronic kidney disease (CKD) affect disease progression and found that some medical tests are more accurate in the prediction of kidney failure (KF) than others.
Although CKD is often considered a single disorder, damage to the kidneys can be caused by many different conditions such as diabetes, inherited disease and some inflammatory conditions. These different pathways to CKD mean that there are varying experiences of symptoms, how quickly kidney function is lost and response to treatments. In all cases, prompt identification and diagnosis give the best chance of effective treatment.
NURTuRE is a unique resource that has been designed to accelerate new research into kidney disease. NURTuRE securely brings together biological samples and medical information (with all the details that could identify an individual removed). The information in NURTuRE provided an important resource for the team to explore how different underlying causes of kidney disease can impact time to KF.
Key findings of the research
Tom and his team showed that there were individual differences in time to KF and death, based on a person’s underlying cause of CKD despite controlling for factors known to impact progression, such as their age, sex and estimated glomerular filtration rate (eGFR). For example, people with diabetic kidney disease (DKD) were seen to progress more quickly to KF.
“Using NURTuRE to analyse large groups of patients with CKD has allowed us to better understand individual differences in disease progression and the impact this has on the effectiveness of Albuminuria testing.” Thomas McDonnell.
Tom and colleagues were also able to look at which medical tests provide the most helpful information for each patient group. Measuring albuminuria, the amount of a protein called albumin in the urine, is commonly used to predict how quickly an individual's kidney disease might progress. Here, it was seen to be most helpful in predicting outcomes for people with vasculitis and DKD, but it was less useful for those with inherited (genetic) kidney diseases.
Thomas added: “We have shown that not everyone with kidney disease will progress in the same way, so it is important to treat patients individually according to their primary diagnosis. New, personalised approaches to managing and treating kidney disease are needed to improve patient outcomes.”
About NURTuRE
NURTuRE securely holds information and biological samples from patients with different types of kidney diseases in the UK, providing a unique resource to support new research. To date, patients diagnosed with chronic kidney disease and idiopathic nephrotic syndrome (INS) are included. A new collection looking at acute kidney injury (AKI) will start in early 2025.
In this study, 2,638 CKD participants from NURTuRE were included in the analysis.
A vital resource
Elaine Davies, director of research operations at Kidney Research UK said: “Identifying new approaches to prevention, diagnosis and care is crucial for kidney patients - it is great to see NURTuRE being used as a vital resource to offer further insights into precision medicine. We would encourage any researchers who are interested in how NURTuRE might support their research to look at our website for further details on our application processes.”
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