A5018328405- Renal Diseases and Glomerulopathies
- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Health Systems, Economic Evaluations, Quality of Life
- Adolescent and Pediatric Healthcare
- Blood Pressure and Hypertension Studies
- Colorectal and Anal Carcinomas
- Pregnancy and Medication Impact
- Chronic Disease Management Strategies
- Healthcare Policy and Management
- Patient Satisfaction in Healthcare
- Coagulation, Bradykinin, Polyphosphates, and Angioedema
- Renal and Vascular Pathologies
- Gastric Cancer Management and Outcomes
- Genital Health and Disease
- Childhood Cancer Survivors' Quality of Life
- Cardiac, Anesthesia and Surgical Outcomes
- Cancer survivorship and care
- Growth Hormone and Insulin-like Growth Factors
- Economic and Financial Impacts of Cancer
- Birth, Development, and Health
- Vasculitis and related conditions
- Ion Transport and Channel Regulation
- Sexual Differentiation and Disorders
- Heparin-Induced Thrombocytopenia and Thrombosis
Cancer Research UK Clinical Trials Unit
2014-2024
University of Birmingham
2014-2024
University College London
2023
Foundation for Growth Science
2023
Renin-angiotensin system (RAS) inhibitors - including angiotensin-converting-enzyme (ACE) and angiotensin-receptor blockers (ARBs) slow the progression of mild or moderate chronic kidney disease. However, results some studies have suggested that discontinuation RAS in patients with advanced disease may increase estimated glomerular filtration rate (eGFR) its decline.In this multicenter, open-label trial, we randomly assigned progressive (eGFR, <30 ml per minute 1.73 m2 body-surface area)...
Blood pressure (BP) control and reduction of urinary protein excretion using agents that block the renin–angiotensin aldosterone system are mainstay therapy for chronic kidney disease (CKD). Research has confirmed benefits in mild CKD, but data on angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use advanced CKD lacking. In STOP-ACEi trial, we aim to confirm preliminary findings which suggest withdrawal ACEi/ARB treatment can stabilize even improve renal...
Background Uterine polyps cause abnormal bleeding in women and conventional practice is to remove them hospital under general anaesthetic. Advances technology make it possible perform polypectomy an outpatient setting, yet evidence of effectiveness limited. Objectives To test the hypothesis that with uterine (AUB) associated benign polyp(s), polyp treatment achieved as good, or no more than 25% worse, alleviation symptoms at 6 months compared standard inpatient treatment. The response...
To determine whether extending initial prednisolone treatment from eight to 16 weeks in children with idiopathic steroid sensitive nephrotic syndrome improves the pattern of disease relapse.Double blind, parallel group, phase III randomised placebo controlled trial, including a cost effectiveness analysis.125 UK National Health Service district general hospitals and tertiary paediatric nephrology centres.237 aged 1-14 years first episode syndrome.Children were receive an extended week course...
In children with corticosteroid-sensitive nephrotic syndrome, many relapses are triggered by upper respiratory tract infections. Four small studies found that administration of daily low-dose prednisolone for 5 to 7 days at the time an infection reduced risk relapse, but generalizability their findings is limited location and selection study population.To investigate use treatment infection-related relapses.This double-blind, placebo-controlled randomized clinical trial (Prednisolone in...
Uncertainty exists regarding the optimal method to estimate glomerular filtration rate (GFR) for disease detection and monitoring. Widely used GFR estimates have not been validated in British ethnic minority populations.Iohexol measured will be reference against which each estimating equation compared. The equations based upon serum creatinine and/or cystatin C. eGFR-C study has 5 components: 1) A prospective longitudinal cohort of 1300 adults with stage 3 chronic kidney followed years...
Relapses of childhood steroid-sensitive nephrotic syndrome (SSNS) are treated with a 4- to 8-week course high-dose oral prednisolone, which may be associated significant adverse effects. There is clear association between upper respiratory tract infection (URTI) and relapse development. Previous studies in developing nations have suggested that introducing 5- 7-day daily prednisolone during an URTI prevent the need for treatment prednisolone. The aim PREDNOS 2 evaluate effectiveness 6-day...
Abstract Background Effective management of patients with chronic kidney disease (CKD) relies on timely detection clinical deterioration towards end stage failure. We aimed to design an electronic Patient-Reported Outcome Measure (ePROM) system, which would allow advanced CKD (pre-dialysis) to: (i) remotely self-report their symptoms using a simple and secure online platform; (ii) share the data team in real-time via patient record help optimise care. adopted staged development process...
Idiopathic sudden sensorineural hearing loss (ISSNHL) is the rapid onset of reduced due to function inner ear or nerve unknown aetiology. Evidence supports improved recovery with early steroid treatment, via oral, intravenous, intratympanic a combination routes. The STARFISH trial aims identify most clinically and cost-effective route administration steroids as first-line treatment for ISSNHL. pragmatic, multicentre, assessor-blinded, three-arm intervention, superiority randomised controlled...
Introduction In liver cirrhosis, acute variceal bleeding (AVB) is associated with a 1-year mortality rate of up to 40%. Data on early or pre-emptive transjugular intrahepatic portosystemic stent–shunt (TIPSS) in AVB inconclusive and may not reflect current management strategies. Randomised controlled trial EArly intrahepatiC porTosystemic (REACT-AVB) aims investigate the clinical cost-effectiveness TIPSS patients cirrhosis after initial control. Methods analysis REACT-AVB multicentre,...
Estimation of glomerular filtration rate using equations based on creatinine is widely used to manage chronic kidney disease. In the UK, Chronic Kidney Disease Epidemiology Collaboration equation recommended. Other published cystatin C, an alternative marker function, have not gained widespread clinical acceptance. Given higher cost its utility should be validated before introduction into NHS.
Introduction Chronic kidney disease (CKD) affects up to 16% of adults in the UK. Patient quality life is particularly reduced end-stage renal and strongly associated with increased hospitalisation mortality. Thus, accurate responsive healthcare a key priority. Electronic patient-reported outcome measures (ePROMs) are online questionnaires which ask patients self-rate their health status. Evidence oncology suggests that use ePROM data within routine care, alongside clinical information, may...
The optimal corticosteroid regimen for treating the presenting episode of steroid-sensitive nephrotic syndrome (SSNS) remains uncertain. Most UK centres use an 8-week regimen, despite previous systematic reviews indicating that longer regimens reduce risk relapse and frequently relapsing (FRNS). primary objective was to determine whether or not extended 16-week course prednisolone increases time first relapse. secondary objectives were compare rate, FRNS steroid-dependent (SDNS) rates,...
Background Anti-neutrophil cytoplasm antibody-associated vasculitis is a multisystem, autoimmune disease that causes organ failure and death. Physical removal of pathogenic autoantibodies by plasma exchange recommended for severe presentations, along with high-dose glucocorticoids, but glucocorticoid toxicity contributes to morbidity mortality. The lack robust evidence base guide the use dosing variation in practice suboptimal outcomes. Objectives We aimed determine clinical efficacy...
Growth hormone deficiency (GHD) is the commonest endocrine cause of short stature and may occur in isolation (I-GHD) or combined with other pituitary deficiencies. Around 500 children are diagnosed GHD every year UK, whom 75% have I-GHD. (GH) therapy improves growth GHD, goal achieving a normal final height (FH). GH given as daily injections until adult FH reached. However, many I-GHD their condition reverses, peak detected 64-82% when re-tested at FH. Therefore, some point between diagnosis...
Background Shiga-toxin-producing Escherichia coli haemolytic uraemic syndrome affects ~100 United Kingdom children each year. Around half need dialysis, a quarter develop serious complications with long-term consequences and ~3% die. No effective intervention is known; however, some studies report eculizumab, in atypical syndrome, may be effective. Objectives To determine whether the severity of less those given eculizumab. Design Randomised, double-blind, placebo-controlled, parallel-group...
The use of routine remote follow-up patients with chronic kidney disease (CKD) is increasing exponentially. It has been suggested that online electronic patient-reported outcome measures (ePROMs) could be used in parallel, to facilitate real-time symptom monitoring aimed at improving outcomes. We tested the feasibility this approach a pilot trial ePROM versus usual care advanced CKD not on dialysis.A 12-month, randomised controlled (RCT) and qualitative substudy.Queen Elizabeth Hospital...
Background Most children with steroid-sensitive nephrotic syndrome have relapses that are triggered by upper respiratory tract infections. Four small trials, mostly in already taking maintenance corticosteroid countries of different infection epidemiology, showed giving daily low-dose prednisone/prednisolone for 5–7 days during an reduces the risk relapse. Objectives To determine if these findings were replicated a large UK population relapsing on background medication or none. Design A...
Background Chronic kidney disease (CKD) affects 1 in 10 adults the UK, and is an increasing burden on NHS dialysis costs ~£30,000/year. Key clinical outcomes CKD are need for or transplantation survival. However, designing trials with these endpoints requires large patient numbers. To reduce sample size requirements, have used measures of renal function (e.g. serum creatinine, glomerular filtration rate), which correlate longer-term outcomes. there interpretation issues parameters if rate...
Abstract Background and Aims At least 80% of children with steroid sensitive nephrotic syndrome (SSNS) have relapses many are triggered by upper respiratory tract infections (URTIs). Previous small studies (4 studies, 232 patients in total), mostly already taking maintenance corticosteroid countries where URTI epidemiology is different to Europe, showed that giving daily low-dose prednisolone for 5-7 days during an reduces the risk relapse. The objective PREDNOS 2 trial was determine if...