New test for kidney disease could reduce dialysis need

A new non-invasive test for kidney disease, developed by clinicians at Hammersmith Hospitals NHS Trust and Imperial College London, is providing a simple, safe, cheap and reliable method of detecting kidney disease. The new test, reported today in the journal Nephrology Dialysis Transplantation, can detect disease before symptoms become apparent, and offers a quicker way of finding out if patients are responding to treatment – which could mean that some patients might not need costly dialysis.

Around 100,000 people in the UK have kidney disease, and the number is increasing, costing the NHS over £2 billion annually. Over 7000 people die from kidney failure every year. “Patients with a progressive kidney disease due to vasculitis* often develop kidney failure, the only treatment for which is dialysis or kidney transplant,” explains Dr Fred Tam, consultant nephrologist at Charing Cross and Hammersmith Hospitals and senior lecturer at Imperial College London. “By looking at a chemical produced when the kidney becomes inflamed, we can test patient’s urine for the level of disease, often before clinical symptoms appear.” The test could eventually replace the need to take biopsies from the kidney – a complicated and uncomfortable surgical procedure.

Current treatments for kidney vasculitis involve using drugs that knock out the body’s immune system. These drugs can cause side effects, including vulnerability to infection and risk of reduced fertility. This new test can accurately measure response to treatment, allowing clinicians to tailor treatments to individual patients. “The test can tell us if a treatment is working, and shows us, before it is too late, if we need to change the medication, without the need to perform a biopsy,” adds Dr Tam.

The test works by identifying the amount of a cytokine molecule called monocyte chemoattractant protein-1 (MCP-1) present in the urine. MCP-1 is produced by the body as a response to inflammation, and attracts white blood cells to the area to combat pathogens. However, overreaction of the white blood cells may also cause vasculitis and organ damage. Each test costs less than £20 to administer. Kidney dialysis costs around £29,000 per year for one patient.

Case study

Mr Noureddine Khallouki from North London was admitted to Hammersmith hospital earlier this year suffering from renal vasculitis, and volunteered to take part in trialling the MCP-1 test. “I was happy to help out, as I think it’s important to give something back. Any new developments that reduce the need to take biopsies is a good thing – the procedure is uncomfortable and meant I was unable to move for about 8 hours afterwards in case of bleeding.” The test showed that Mr Khallouki was responding well to treatment and he has since made a full recovery.