The National Kidney Federation (NKF), Kidney Research UK and Kidney Wales are joining forces to fund a new research study to discover how well Covid-19 vaccines work in people who go to hospital for their dialysis treatment (haemodialysis).

Dr Michelle Willicombe and Dr Steve McAdoo at Imperial College London, with Dr Ed Carr from Dr Rupert Beale's lab at the Francis Crick Institute, will study how well these vaccines provide immunity to Covid-19 infection. It will tell us how long this immunity lasts and ultimately how well these vaccines can protect dialysis patients.

Covid-19 vaccines are being rolled out across the world in the fight against the virus. But although the vaccines have been tested in many people in clinical trials, these trials didn't specifically include people with kidney disease.

This study will begin by investigating how people on haemodialysis respond to the vaccines, and we hope will be expanded to include other kidney patients. We expect other funders to join us soon and help make this happen. Several Kidney Patient Associations (KPAs) including Wessex Kidney Patient Association (KPA) and Exeter & District have already joined us, with several KPAs and fellow kidney charities following soon.

The study complements the OCTAVE study funded by the Medical Research Council, which is studying how well vaccines work in a wide range of vulnerable patients with different health conditions.

Covid-19 protection is crucial

If kidney patients catch Covid-19, they are more likely to become more seriously ill or die from the infection than the general population. Many of them have protected themselves by shielding, but often they can't shield properly because they must regularly attend hospital for their life-saving treatment.

"Vaccines are the best way to protect kidney patients," said Sandra Currie, chief executive of Kidney Research UK. "But we don't currently know how well kidney patients respond to them, how much protection they offer and how long it might last."

"With other vaccines such as flu or hepatitis B, the degree of kidney disease or whether someone is taking immunosuppressants means they don't always work as well as they should," she explains. "It's vital we understand how effective the Covid-19 vaccines are, so patients know if other protective measures are also needed - whether they need to continue shielding, for example. This information will also help doctors tailor treatment for them - including identifying the best time they should receive booster doses."

Dialysis first

This study is starting with people attending hospital for haemodialysis. These patients are at greater risk, having to travel to hospital for life-saving treatment three times a week, and have been shown to fare particularly badly if they develop Covid-19.

The research team will take blood samples from more than 1,200 patients across the UK before they receive their first vaccine and compare the results with samples taken three to four weeks after both their first and second dose of vaccine. They'll also test again after six to 12 months. Scientists at the Francis Crick Institute will analyse the samples to determine how the immune response changes over time.

Analysing these samples will enable the researchers to build up their knowledge about the pattern of immunity and establish if this vulnerable group of patients is protected in the short and long term. The study will also look at whether other factors are important, such as age, type of vaccine, ethnic background, kidney disease stage, and any other health conditions that patients are living with, such as diabetes.

Ultimately, this study will find out if the vaccines stop Covid-19 infection in kidney patients and how severe it is if they are infected, and if they stop patients dying from it.

A trial tailored for kidney patients

This research is the first step towards better understanding how well Covid-19 vaccines work in patients with kidney disease and may reveal ways to prevent the infection spreading, reduce disease severity, and save lives. Doctors could know how well their patients are protected and for how long, which will enable them to advise their patients better about when they can stop shielding and return to a more normal life. Patients could be able to travel to hospital for their dialysis treatment without worry.

"We are delighted to be funding this vital piece of research with the NKF that is so important for kidney patients, who are so vulnerable right now," explains Sandra. "Our study will reveal how well the vaccines protect them.

"This is just the start, and we hope this trial will extend to a broader group of people, who also need answers. People who've had kidney transplants or are at another stage in their kidney journey also need to know how well they are protected."

Andrea Brown, chief executive of the NKF, said: "We are delighted to partner with Kidney Research UK to fund this crucial vaccine study. It was important for us to contribute to funding this study, which will help kidney patients be more informed about protecting themselves from Covid-19. We look forward to working together and are looking forward to seeing the results."

Dr Steve McAdoo said: "We'd like to thank Kidney Research UK and the NKF, and their supporters, for funding this vital work. There is a real chance this study will lead to changes in dialysis care within the next 12 months, such as highlighting the best time for them to receive for them to receive their booster doses, to better protect dialysis patients from Covid-19."

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