Project Title

Establishing a clinical phenotype for cachexia in end stage kidney disease

Research Focus:

Chronic Illness and Palliative care

Funder & Dates

R&D Office PHA (01.09.16) & NIKPA (01.11.17)

Principal Investigator or Primary Supervisor (if PhD project)

Professor Joanne Reid (PI)

Co-Investigators or additional supervisors

Professor Peter Maxwell, Belfast City Hospital/QUB; Dr Helen Noble, QUB; Dr Joanne Shields, Belfast City Hospital; Professor Sam Porter, Bournemouth University; Dr Adrian Slee, UCL.

Research Fellow(s) or PhD Student

Clare McKeaveney (RF)

Name & Institution of Collaborators

Professor Gary Adamson, Ulster University; Dr Andrew Davenport, UCL; Dr Ken Farrington, East and North Hertfordshire University; Professor Denis Fouque, Lyon University; Dr Kamyar Kalantar-Zadeh, University of California; Dr John Mallett, Ulster University; Associate Professor David Seres, Columbia University Medical Centre; Dr Miles D. Witham, Ninewells Hospital.

Name of External Partner Organisations

Description of Project:

Aim; Methods; Expected Outcomes

Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD. Individuals with ESKD often exhibit symptoms of anorexia, loss of lean muscle mass and altered energy expenditure. These symptoms are consistent with the syndrome of cachexia observed in other chronic diseases, such as cancer, heart failure, and acquired immune deficiency syndrome. The aim of this study is to determine the clinical phenotype of cachexia specific to individuals with ESKD.  A longitudinal study will recruit adult chronic haemodialysis patients attending a Regional Nephrology Unit within the United Kingdom. Patients will be followed 2 monthly over 12 months and measurements of weight; lean muscle mass (bioelectrical impedance, mid upper arm muscle circumference and tricep skin fold thickness); muscle strength (hand held dynamometer), fatigue, anorexia and quality of life to determine if they experience (and to what degree) the known characteristics associated with cachexia.Outcomes from this study will provide much needed data to inform development and testing of potential treatment modalities, aimed at enhancing current clinical practice, policy and education.    

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