24/09/18

AEG Raine Award awarded to Alex Hamilton

The Raine Award was established in memory of Tony Raine, Professor of Renal Medicine at Barts, following his tragically early death in 1995. This year The Renal Association is delighted to award the Raine Award to Dr Alex Hamilton.

Dr Hamilton describes his work:

“My PhD thesis (University of Bristol) was titled ‘The clinical and psychosocial status of young adults receiving renal replacement therapy in the United Kingdom’, and was funded by Kidney Care UK and Kidney Research UK. I was supervised by Prof Yoav Ben-Shlomo, Dr Fergus Caskey and Dr Carol Inward. My research has been methodologically rigorous, involving evidence synthesis, use of national disease registries and a large multicentre survey study (SPEAK: Surveying People Experiencing young Adult Kidney failure) with linkage to the UK Renal Registry.

The use of evidence synthesis has enabled the quality of the existing literature to be understood, so that deficiencies could potentially be addressed in future studies. Further, estimates for psychosocial outcomes could be estimated. We found impaired psychosocial health (limited employment, independence and relationships) compared with healthy peers, but no difference in higher education. By uniquely linking UK Renal Registry paediatric and adult datasets, clinical characteristics, treatment and survival could be examined for incident young adults. We found glomerulonephritis was the leading primary renal disease. Initial haemodialysis use was frequent (52%). By five years, 78% were transplanted, while 11% remained unlisted, which was associated with poorer survival compared to transplantation.

Finally, a national cross-sectional survey study involving all UK renal units was undertaken, using validated measures with normative comparator data from the Health Survey for England and Avon Longitudinal Study of Parents and Children. Young adults on renal replacement therapy were less likely to have a relationship or children; more likely to live in the family home, to receive no income and be unemployed for health reasons. They had poorer quality of life and wellbeing with increased psychological morbidity. A screening questionnaire identified more psychological morbidity (31%) than declared by responders (17%). They reported less smoking, alcohol, drug abuse and crime.

This study allowed associations with wellbeing and medication adherence to be examined, which are key areas for this patient group. Wellbeing and medication adherence were both associated with psychologic morbidity in young adults. Dialysis treatment is associated with poorer wellbeing and medication adherence. Future work plans to test interventions to improve psychosocial health in young adults.”

The provisional Raine Award Lecture title: ‘The clinical and psychosocial status of young adults receiving renal replacement therapy in the United Kingdom’.