New research will look at how novel methods of kidney MRI scanning can help improve diagnosis and treatment for people living with kidney disease, thanks to a £1.9 million grant from the Efficacy and Mechanism Evaluation (EME) Programme – a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership.
Researchers from University Hospitals of Derby and Burton NHS Foundation Trust and the University of Nottingham, will use multiparametric MRI scanning to assess patients suffering with long-term reductions in kidney function, known as Chronic Kidney Disease (CKD).
The study, called ‘AFiRM’, will be led by Dr Nick Selby and Professor Maarten Taal from the Centre for Kidney Research and Innovation (CKRI), and Professor Sue Francis from the Sir Peter Mansfield Imaging Centre (SPMIC) at the University of Nottingham.
Multiparametric MRI scanning incorporates several different MRI techniques into a single scanning session. This allows assessment of processes that influence or cause kidney disease, such as changes in blood flow, oxygen levels and the degree of scarring (fibrosis). Unlike X-rays and CT scans, MRI scans do not use radiation and patients do not need dye injections, making it completely safe for patients to be scanned on multiple occasions.
The AFiRM study has three stages, with the first stage testing the scanning technique on a small number of patients to demonstrate that it is working well and that the process is acceptable. In the second stage, 450 patients with CKD will be invited to have multiparametric MRI scans of their kidneys, which will be repeated after two years. Their progress will then be followed and their kidney function assessed with annual check-ups.
The third aspect of the research study will focus on a smaller group of patients who take part in the research but who have also had a kidney biopsy as part of their usual care. A biopsy is currently the only way to directly see disease processes inside a patient’s kidneys. Analyses to compare MRI results against kidney biopsy will be performed to provide additional, more detailed evidence as to how multiparametric MRI can be used to visualise different disease processes that lead to CKD.
Dr Nick Selby, Honorary Consultant Nephrologist at University Hospitals of Derby and Burton NHS Foundation Trust and Associate Professor of Nephrology at the University of Nottingham, said: “At the moment, most people with kidney disease have only a basic ultrasound scan that provides only a small amount of information about the structure of the kidneys, and no information on their function or the type of disease affecting them.”
“This research study is extremely exciting because it will show us how advanced MRI scanning techniques can be used to give us more information about the nature of kidney disease that individuals are experiencing. Ultimately, we hope that this will improve how we plan and monitor treatments.”
Professor Danny McAuley, Director of the NIHR Efficacy and Mechanism Evaluation (EME) Programme, said: “This is a very important area of research. Advanced scanning techniques provide an area of great potential in assessing and diagnosing kidney disease with less risks for patients. This could offer real benefits for clinical care and long-term health of patients with kidney disease.”
The study will be managed by the team at Derby Clinical Trials Support Unit at the Royal Derby Hospital, and take place in eight UK centres in addition to Derby and Nottingham. The study will begin in September 2020 and run for seven years.