MAP-KD
Research type
Research Study
Full title
MetAbolic, Immunological and Pathological Factors in Kidney Disease
IRAS ID
240492
Contact name
Alice C Smith
Contact email
Sponsor organisation
UHL
Clinicaltrials.gov Identifier
18/EM/0031, EM Derby
Duration of Study in the UK
4 years, 1 months, 30 days
Research summary
Our research team carry out a range of studies investigating lifestyle factors such as physical activity, physical function, nutrition, symptom experience and quality of life in people with kidney disease, and develop and test ways that kidney patients can manage their lifestyle to improve health and wellbeing. During all our studies we collect blood and urine samples which we analyse in the lab to better understand the disease processes underlying the effects that we see. In the long run this will help us to design the best ways to help and advise patients, and to identify the most effective treatments for each individual patient. Our lab work includes analysing genes, factors and cells in the blood. Some of these are quite newly discovered and we do not know enough about how they change over time, differ between patients or are related to long term outcome. The MAP-KD study is designed to help us learn more about these genes, factors and cells so we can make the best use of the information we gather from our other studies. In the MAP-KD study we will ask kidney patients and controls who do not have kidney disease to give a sample of blood and urine, carry out some simple tests of their health and physical function, and fill in some questionnaires. Some participants will be invited to return for further blood and urine samples, tests and questionnaires up to 6 times over the next 3 years. However, these subsequent visits are optional.
Summary of Results
The MAP-KD study (MetAbolic, Immunological and Pathological Factors in Kidney Disease) aimed to investigate how the levels of a variety of proteins and other factors differ in the blood and urine of those who have kidney disease, compared to those who do not. Identification of these differences is an important step in designing new therapeutic interventions. This study particularly focussed on cardiovascular risk factors, muscle deterioration, and inflammation. The longer term aim is to identify and develop lifestyle interventions such as exercise to improve the health of people living with kidney disease. 37 people volunteered to participate in the study : 8 kidney transplant recipients, 14 people with early-stage chronic kidney disease (CKD) and 15 people who do not have kidney disease (controls). We collected blood and urine samples from all the participants and also did some tests of physical function and fitness. Lab analysis gave a wealth of information about differences in the blood cells and factors of people with kidney disease :
1. People with kidney disease have higher levels of inflammatory cytokines in their blood, which have been shown to be partially responsible for the muscle weakness noted in this population (link to manuscript below (1)).
2. People with kidney disease have higher levels of a compound called Chemerin in their blood and urine, which is related to high levels of inflammation and reduced muscle mass (manuscript currently in preparation)
3. People with a kidney transplant can undertake high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) without negative effects on the immune cells in the blood. This was previously a concern to those who had received a kidney transplant and is the first research of its kind (link to manuscript below (2)).
4. Factors extracted from the blood of people with kidney disease can exert similar effects on muscle cells grown in the lab as we see in the living human being. This novel work will allow us to identify and target ways to prevent muscle loss and weakness in the future (link to manuscript below (3))
5. We have identified a kidney disease-specific panel of blood proteins which may provide a quick and simple way to diagnose clinically significant loss of muscle mass or function. This work is being taken forward in our ongoing research studies.
Links to Publications
1. Inflammation and physical dysfunction: responses to moderate intensity exercise in chronic kidney disease | Nephrology Dialysis Transplantation | Oxford Academic (oup.com)
2. Effect of high intensity interval training and moderate intensity continuous training on lymphoid, myeloid and inflammatory cells in kidney transplant recipients - PubMed (nih.gov)
3. Primary skeletal muscle cells from chronic kidney disease patients retain hallmarks of cachexia in vitro - Baker - 2022 - Journal of Cachexia, Sarcopenia and Muscle - Wiley Online LibraryREC name
East Midlands - Derby Research Ethics Committee
REC reference
18/EM/0031
Date of REC Opinion
3 Apr 2018
REC opinion
Further Information Favourable Opinion