Research at SRFT: My experience as a Clinical Research Fellow

Research at SRFT: my experience as a Clinical Research Fellow

Hi! My name is Diana and I am one of the Clinical Research Fellows within the Renal Department at SRFT. My career in Renal Medicine started in 2011 as a Specialist Trainee in Renal Medicine. I have always been intrigued by the world of research and in 2014 I joined the research team at SRFT as a Clinical Research Fellow. My area of interest in renovascular disease i.e. the condition caused by narrowing of one or both renal arteries supplying the kidney, and I hope to obtain a higher degree (e.g. MD or PhD) through my work.

I admit that when I started my job last August, I did not quite know what to expect. Life as a clinical nephrology trainee can be hectic but extremely rewarding and the diverse challenges encountered on the renal ward or the dialysis unit are what initially attracted me to renal medicine as a speciality. Hence, I was quite apprehensive about spending time away from my ‘comfort zone’ (aka Ward H3!)

The fated day finally arrived, and I stepped gingerly into the world of academia. What I immediately realised is that there is a whole new world of research busy at work behind the scenes of the clinical world. I soon discovered a new family – 13 friendly research nurses all working on different research projects.

Professor Kalra is the renal research lead at SRFT and he has been crucial in developing an active research department, which attracts important research and clinical trials from around the world, essentially putting SRFT on the international research map. Indeed, the research studies he has helped develop have shaped the way patients with kidney disease are currently treated. There are currently an amazing 4000+ renal patients enrolled into 27 different research projects here. A quarter of these studies are funded by a pharmaceutical company, and they can involve the administration of new drugs or the use of new technology. These studies have gone past the laboratory stage (Phase 0 of a clinical trial) and are usually at a later stage (Phase 2 or 3) where the aim is to confirm that the medication studied is safe and ‘does what it says on the tin’.

The rest of the studies are academic research studies i.e. they are driven by researchers or research groups and funded by charities or trusts. These studies aim to generate new knowledge about a certain condition in order to improve patient care. Both Academic and Commercial studies can be either observational (involve simply the collection of patient data e.g. through questionnaires or looking at patient notes) or interventional (involve the administration of medication).

So what does my job as a Clinical Research Fellow involve? When a new research study is proposed, I attend the ‘Site Initiation Visit’, a meeting during which all the study details are presented to us by the company or individual who initiates the study). Next, the research nurses identify and approach patients who are the right ‘fit’ for the study. My job is to obtain ‘informed consent’ i.e. I ensure that our patients have understood all the information provided to them in the Patient Information Sheet. I answer any questions that they might have before they make their mind up about taking part in the research. My next role is to review any blood tests that they may have taken as part of the study, prescribe any study medication as per the study protocol and deal with any issues that might crop up during the course of their participation in the study. In the case of a placebo-controlled study, these are ‘blinded studies’ hence I am not even aware if the patient is receiving study drug or a fake (placebo) in order to avoid bias which may affect results.

Apart from helping out with clinical trials, I am also carrying out my own research project in which I am collecting data about people with renovascular disease. My aim is to see whether there are any factors which influence how fast kidneys get more poorly in this population, and whether we can identify these patients at an earlier stage. Indeed, although some recent large clinical trials have shown that patients with narrowed renal arteries gain no extra benefit from having an intervention to restore blood supply to the kidneys (renal revascularisation or stenting), my research colleagues at SRFT, working under the supervision of Professor Kalra, have identified that in fact some very specifically chosen patients can benefit from this procedure.

I have recently attended the PCPIE day (Patient, Carer and Public Involvement and Engagement) held at the Macron stadium on the 17^th May. It was a real pleasure to see ‘my renal patients’ out of the hospital and looking well! It was an opportunity for them to meet other patients with kidney disease and research staff in an informal environment, encouraging them to ask questions that they might otherwise have difficulty asking in a hospital environment.  This event helped increase patients’ understanding of research while clearing any misconceptions about the whole process. After all – it’s only by working together that scientists, doctors’ kidney patients and their families can all help create a better future for those affected by kidney disease.

On looking back at the past 9 months, I can honestly say that my experience in research has been invaluable in helping me develop new skills, and has provided intellectual challenges different from those encountered during routine hospital duties. I believe that this research experience will provide me with a unique opportunity to help contribute towards medical knowledge in order to continue improving the care of renal patients.