We would like to collect and test samples from people with cirrhosis who are admitted to our unit to search for new biomarkers of kidney damage and to see if there are differences in these biomarkers between patients who recover fully and those who do not. We hope that this research will lead to a better test for kidney damage that might improve outcomes for people with cirrhosis.
We are undertaking a research study to identify substances that are released into the blood or urine when the kidney is damaged in people with cirrhosis. These substances (so called ‘biomarkers’) might enable us to detect kidney damage more quickly so that appropriate treatment can be started promptly. Acute kidney injury (AKI) is a common and under-diagnosed problem in patients with liver cirrhosis, and is associated with significant illness and preventable death. Blood (serum) creatinine is the current test for kidney function, but it is an insensitive and non-specific marker in cirrhosis. We hypothesise that blood (plasma) levels of kidney injury molecule-1 (KIM-1) will detect AKI earlier and predict the risk of worsening AKI in cirrhosis, thus identifying patients in need of prompt and effective treatment and improving patient outcomes. We will collect blood and urine samples from cirrhosis patients admitted into hospital and study the relationship between plasma KIM-1, other diagnostic ‘biomarker’ tests that have recently been proposed, and patient outcomes.
Diagnostics devices play an important part in the clinical assessment of a patient’s health and treatment. The purpose of the study is the evaluation of a new diagnostic platform developed by LumiraDx. The evaluation is focused around various biomarkers useful in the emergency settings.
Collection of venous and capillary blood samples for the evaluation of new diagnostic devices for cardiovascular conditions
Trauma remains a major cause of mortality and morbidity. 10% of blunt force trauma patients admitted to a major trauma centre will have sustained one or more fractured ribs, which may cause significant pain and problems with breathing.
To establish the outcome of rib fractures and their treatments it is important to know what to measure, and how to measure this accurately. A patient reported outcome measure (PROM) is a questionnaire used to measure patient reported outcomes, to show how the patient is doing from their perspective.
Whilst there is ongoing interest in surgery to fix broken ribs, there is no PROM specifically designed for patients with broken ribs following chest trauma. Therefore, it is not clear whether the symptoms that are most important to these patients are being represented by the current outcome measures. This study aims to create a PROM specific to rib fracture patients to give us a better understanding of whether a new treatment actually makes a difference to the patient’s recovery.
The 1st part of the study involves asking patients with rib fractures to help design a new PROM. This will be conducted through focus groups at a site in Nottingham. The 2nd part of the study entails field testing, whereby patients with rib fractures will be asked to test this new PROM. This will be conducted across multiple secondary care settings in the UK, including the Royal Infirmary of Edinburgh. The study is expected to run for approximately 2 years, with recruitment targets of 50 patients for the PROM Creation phase and 250 for the Field Testing phase.