March is Kidney Health month, which is an opportunity to highlight the great work the Renal department does for the Counties Manukau catchment. Counties Manukau Health (CMH) Renal service is the largest Renal department in New Zealand due to the highest prevalence of patients requiring dialysis, at 4% in 2020. Maaori and Pasifika patients make up 80% of our patients. Currently we have 700 dialysis patients, 230 of whom do their dialysis at home. In our dialysis population, diabetic kidney disease is the most common cause of end stage kidney disease (ESKD) accounting for 2/3 of the patients.
The CMH Renal department provides a wide range of services both in-patient and out-patient for acute and chronic presentations, for all fields of Nephrology, including: dialysis, renal transplantation, chronic kidney disease, hypertension, supportive care and procedures. We have a particular focus amongst our whole team on home based dialysis and renal transplantation.
The team of physicians are also engaged in both commercial and grant-funded clinical research. This allows the team to bring novel treatments and observational studies to the CMH population.
Two particular areas of unmet need in Nephrology research would be:
- Therapeutics to slow the progression of diabetic nephropathy and thus reduce the incidence of ESKD from this aetiology
- Improving cardiovascular outcomes in ESKD patients
In broad terms by taking part in clinical trials the CMH Renal department hopes to improve outcomes for all renal patients in terms both of quality and quantity of life. Currently, the Renal department are conducting two commercial trials and two grant-funded trials.
Principal investigators currently:
Dr Jamie Kendrick-Jones is the clinical lead of the department at Counties Manukau Health. His research interests include peritoneal dialysis, lupus and vasculitis.
Dr Kalpa Jayanatha is a Consultant Renal Physician at Counties Manukau Health and a Senior Lecturer at the University of Auckland. Dr Jayanatha has a special interest in glomerulonephritis, in particular IgA nephropathy and chronic kidney disease.
Dr Hari Talreja is a Consultant Renal Physician at Counties Manukau Health and is the Clinical Lead for Hypertension. Dr Talreja led the development of the Hypertension Clinic at CMDHB and has a special interest in this area of research.
Current recruiting trials:
- ALIGN Study - PI: Dr Kalpa Jayanatha
The ALIGN study is testing atrasentan, an investigational medication that has the potential to reduce proteinuria and preserve kidney function in patients with IgA nephropathy.
- Polypill Active - PI: Dr Hari Talreja
A single pill combination compared to dual combinations for the treatment of hypertension: An international, multi-centre, randomised, double-blind, active-controlled, parallel-group trial.
- Phosphate - PI: Dr Hari Talreja
Pragmatic randomised trial of High Or Standard PHosphAte Targets in End-stage kidney disease
- Teach-PD - PI: Dr Jamie Kendrick-Jones
Target Education ApproaCH to improve Peritoneal Dialysis Outcomes Cluster Randomised Controlled Trial (CRCT)
The team at MMCT are looking forward to continuing our collaboration with the Renal department to ensure better health outcomes for our local community.