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Last Updated: Friday, 17 September, 2004, 14:11 GMT 15:11 UK
Kidney test may cut dialysis need
Test
Test gives fast results
A new test can detect kidney disease triggered by inflammation of the blood vessels before symptoms become apparent.

It also offers a faster way of telling whether people with the condition are responding to treatment.

Researchers at Imperial College London hope it will cut the need for some people to undergo dialysis.

Details of the test are published in the journal Nephrology Dialysis Transplantation.

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.
Dr Fred Tam
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.

The new test is designed to spot kidney disease in patients whose symptoms are the result of a group of blood inflammation diseases known collectively as vasculitis.

These patients often go on to develop kidney failure, which can only be treated by a dialysis or a kidney transplant.

Key chemical

Researcher Dr Fred Tam, a nephrologist at Charing Cross and Hammersmith Hospitals, said: "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.

The new test can accurately measure response to treatment, allowing clinicians to tailor treatments to individual patients.

Dr Tam said: "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."

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, over-reaction 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.

Volunteer

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.

He said: "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 eight 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.

Nick Turkentine, of the National Kidney Research Fund, said: "To date, the gold standard test has been renal biopsy which carries risks and cannot be repeated very frequently.

"A test such as this is simple, safe, cheap and can be repeated very often. As such, this will allow us to steer a better course between over- and under-treating these patients and they will undoubtedly benefit significantly."




SEE ALSO:
Graft hope for dialysis patients
15 Aug 04  |  Health
Better kidney care plan unveiled
14 Jan 04  |  Health
Kidney failure
22 Sep 04  |  J-M


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