My group’s research focuses on the cardiovascular risk associated with the spectrum of chronic kidney disease from early in the disease trajectory through to end-stage renal failure requiring either dialysis or kidney transplantation. We perform pre-clinical and clinical pharmacology studies as well as investigating cardiovascular risk at a population level. Our goals are to identify cardiovascular risk early in patients with CKD and, through to investigate novel therapies that might reduce this risk and so improve longer-term patient outcomes.

Current projects

1. The role of innate immunity in hypertension & vascular dysfunction

Using macrophage depleting and modifying strategies we are investigating the role of this very plastic cell in the development and complications of hypertension. We use a number of mouse models of disease including high salt diet, endothelin-1 infusion and angiotensin II infusion.

2. The transition from acute kidney injury (AKI) through to chronic kidney disease

Here we use a mouse model of ischaemia-reperfusion injury to investigate new experimental medicine strategies to reduce the risk of developing CKD after AKI.

3. Chorioretinal thinning in chronic kidney disease

Using optical coherence tomography (OCT) we have recently shown that the retina and choroid are thinned in patients with CKD (see videos 1 & 2) and this thinning relates to the degree of renal dysfunction as well as inflammation and endothelial dysfunction. We are now exploring the utility of these OCT measures as potential end points in experimental medicine studies.

4. The role of microRNAs in small vessel vasculitis

We are currently exploring the role of specific microRNAs as biomarkers of disease activity in ANCA vasculitis. Our clinical studies are supported by relevant pre-clinical models where we are investigating the roles of these microRNAs as mediators of renal and extra-renal disease.

5. Assessment & treatment of cardiovascular disease in patients with chronic kidney disease

Using large datasets we are investigating the role of high sensitivity troponin I as a measure of outcome in CKD patients presenting to the emergency department with chest pain. Using meta-analyses we are exploring the therapeutic disenfranchisement that CKD patients suffer in terms of pharmacological management of their cardiovascular disease.