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Royal Free kidney stone study seeks patients

Dr Shabbir Moochhala

The Royal Free London NHS Foundation Trust (RFH) is looking for patients to take part in a new study which could offer treatment for a rare condition called hyperoxaluria. The condition causes kidney stones and can also cause kidney failure.

Hyperoxaluria occurs when a substance called oxalate builds up in the kidneys. Oxalate appears naturally in many common foods including almonds, spinach and rhubarb, as well as naturally - but usually safely - in the body.

In people with primary hyperoxaluria however, a gene which regulates this process is faulty. Too much oxalate is produced and collects in the kidneys and other organs, forming solid crystals. Over time, the built-up oxalate can lead to kidney stones and damage the body’s organs’ ability to function.

“Hyperoxaluria is a problem for the whole body, not just the kidneys,” said Dr Shabbir Moochhala, consultant nephrologist at the Royal Free and Chief Investigator for the study.

“Unfortunately, all we can currently do to manage the condition is ask patients to drink plenty of fluid – about three litres per day – which helps the body to dilute the oxalate, leaving less to build up in the kidneys. We also use Vitamin B6, but even that is only effective in a very small proportion of patients with hyperoxaluria.”

The study involves a new injectable drug that directly targets the gene which causes oxalate to first build up in liver cells. By ‘silencing’ the gene, the disease cannot progress. Previous studies show that the treatment targets the gene specifically in liver cells but does no harm to cells elsewhere in the body.

Dr Moochhala said: “There’s currently no treatment for this genetic and sometimes hereditary condition so this trial could be a real game-changer.”
The Metabolic Kidney Stone Service at the Royal Free is one of only a handful of clinics in the UK that specialises in the diagnosis and treatment of rare conditions that can cause recurrent kidney stones.

Dr Moochhala is running trials of new drugs that could be effective in treating primary hyperoxaluria and enteric hyperoxaluria. The opportunity for patients to take part in research is embedded into the renal clinical service at the Royal Free London. To find out more about how to take part in the study or to find out more about the service please contact Dr Moochhala on smoochhala@nhs.net or visit the National Registry for Rare Kidney Diseases at https://rarerenal.org/radar-registry/