Dr David Makanjuola MD FRCP
Consultant Nephrologist St. Helier Hospital
The continued commitment to awareness and research from individuals and organisations is helping to improve the lives of those living with kidney disease.
An article about diabetes and kidney disease published in the Kidney International Reports Journal describes how a new marker in the urine might be more sensitive than traditional markers in the detection of patients with diabetes who are developing kidney disease.
Challenges in diagnosis
Around 25 to 30% of people with diabetes develop kidney disease; in fact, diabetes is the single greatest cause of kidney disease globally. Unfortunately, kidney disease, like kidney cancer, is notoriously difficult to diagnose in the early stages.
This article came to mind after I had seen a patient in her eighties in the clinic. She had developed kidney failure about 40 years ago. Kidney failure is life threatening, but we have life-sustaining therapies such as dialysis. Dialysis is, however, not a cure for kidney disease. The patient, let’s call her Pam, went onto dialysis and then received a kidney transplant. More than 30 years later, that transplanted kidney is still working, but most likely as a side effect of the medication needed for the transplant, she developed diabetes.
People might not appreciate it, but ‘Pam’ was a visionary. She teamed up with the nephrologist who had been treating her, and other patients with their friends and families, to create a charity dedicated to supporting research into kidney disease, the South West Thames Kidney Fund.
Around 25 to 30% of people with diabetes develop kidney disease; in fact, diabetes is the single greatest cause of kidney disease globally.
Creating new channels for research
This remarkable group of people raised three quarters of a million pounds (£1.5 million now) and built a research institute, the South West Thames Institute of Renal Research (SWTIRR) at St. Helier hospital. The Institute has been at the forefront of research into various aspects of kidney disease and has provided a base from which around 20 trainee doctors have gained research experience. Many were awarded masters and doctorates; all have gone on to make their mark, locally, nationally and internationally. One of them is the first Professor of Nephrology at the St. Helier Renal unit.
‘Pam’ was the secretary of the charity for many years, working with like-minded people to see the vision through. The charity, now called The Kidney Fund, continues to live up to its objectives, promoting research and increasing awareness of kidney disease.
The article I mentioned at the start of this piece, was on work done at SWTIRR, which showed that traditional markers in the urine of patients with diabetic kidney disease may be less sensitive than newer markers and that these ‘new’ markers might identify diabetic kidney disease earlier. This discovery might give doctors the opportunity to intervene earlier and improve the outcomes in patients.
Improving life for future patients
It struck me as quite interesting that Pam had played a part in bringing about something which will improve the lot of patients in the future. One wonders whether if we had this sort of information when she was first diagnosed, she might have avoided kidney failure.
What is noteworthy is that Pam didn’t just sit back, she chose to try to make things better, not for herself but for those who follow. She showed that you can make a difference.
Pam and many like her, who don’t sit back, but selflessly do whatever they can to facilitate awareness and research into kidney disease, are the reason why we will continue to make progress, why we will understand more and why we will continue to improve the lives of people living with kidney disease.