About the Project
The project will investigate the prevalence of ACKD in Wales across primary and secondary care. It will follow patients with CKD G3-5 to explore the association between ACKD and hospitalisation and mortality. The project will explore the association between ACKD and outcomes in patients ‘known to renal’ (referred to nephrology) and ‘not known to renal’, and explore the association between anaemia therapy and outcomes in primary and secondary care.
- ACKD is an independent risk factor for hospitalisation and mortality in Wales
- Being ‘known to renal’ positively impacts hospitalisation and patient survival rates
- Receiving suboptimal ACKD therapy in primary or secondary care negatively impacts hospitalisation and survival
The project will utilise best available patient data from Wales’ world-class SAIL (Secure Anonymised Information Linkage) Databank, which comprises anonymised person-based data about the population of Wales and is used to support research impacting health and well-being. Patient linkage will be made anonymously between secondary care/nephrology information (e.g. secondary care prescribing data, referral to renal, emergency admission to hospital, first dialysis treatment date, kidney transplantation date and date of death) and primary care data (e.g. demographics, biochemistry, haematology and GP prescribing data). The project will comprise:
• Prevalence study – The prevalence of ACKD in Wales. The prevalence of CKD G3-5 in primary care was reported in the recent National CKD Audit (2015-2016). This project will use cotemporary data to identify the population prevalence of CKD (using eGFR) and ACKD (using Hb levels) in Wales, uniquely across primary and secondary care. The dataset will include demographic details including age, gender, ethnicity and postcode. Variables associated with anaemia will include diabetes mellitus and cardiovascular disease. Medication associated with- and used to treat anaemia will include oral iron, folic acid, antiplatelets, anticoagulants, renin angiotensin aldosterone system inhibitors (RAASi) and non-steroidal anti-inflammatory drugs (NSAIDs). This prevalence study will be of significant value to clinicians and will inform subsequent chapters of this study.
• Incidence study – Following patients (prospectively) with CKD G3-5 to explore the association between ACKD and outcomes that matter to patients; including emergency hospital admission, GP consultations and mortality. The study will explore the association between ACKD and outcomes in patients ‘known to renal’ and ‘not known to renal’, and may provide information on the accessibility and utilisation of specialist renal services across Wales.
The incidence study will also explore the association between anaemia therapy and outcomes in primary and secondary care. Intravenous iron and ESA therapy is generally provided by specialist renal units in Wales; therefore secondary care prescribing data will be included for analysis, along with primary care GP prescribing data for oral iron and other pertinent medications.
The project is unique in terms of the access to a robust patient dataset within the single healthcare system (NHS Wales) across two healthcare sectors, and may identify areas for improvement in clinical practice.
The PhD opportunity is a full time 3 year programme working with clinical specialists in renal medicine (Morriston Renal Unit) and academic researchers (Schools of Pharmacy and Medicine, Cardiff University).
Currently the opening is only available to those candidates able to evidence sponsorship for their PhD tuition fees and subsistence costs (3 years of study).
Applicants must have obtained a First or Upper Second Class UK Honours degree, or the equivalent qualification gained outside the UK, in an appropriate area of science.
To apply please complete the online application - https://www.cardiff.ac.uk/study/postgraduate/research/programmes/programme/pharmacy and state the project title and supervisor name
This PhD studentship is designed for a candidate with a passion to develop skills as a researcher in healthcare interventions and use evidence to improve clinical decision-making and influence the development of practice guidelines; the particular project is focussed upon outcomes in patients diagnosed with chronic kidney disease and anaemia of chronic kidney disease.
For more information specific on this project please contact:
Justine Jenkins, Research and Engagement Manager, 029 20875811 JenkinsJ@cardiff.ac.uk