This article is part of our special report Europe’s ‘decade of the kidney’.
New technologies for treating chronic kidney disease (CKD) are opening up possibilities for improving patients’ quality of life, with the European Union pledging to ramp up health funding and research initiatives in the wake of the COVID-19 pandemic.
Not many substantial breakthroughs have been experienced in the field of CKD treatment since the mass diffusion of dialysis units in the 1970s, with slow progress in recent decades partly attributed to a lack of funding and research incentives.
However, effective and well-funded research programmes in this field could become an acid test for the EU’s renewed ambition on health which has become a key priority as Europe recovers from the COVID-19 pandemic.
“We are going to be taking ambitious steps in the area of health and, also importantly, when it comes to research on Horizon [the EU’s programme for innovation],” Health Commissioner Stella Kyriakides told the annual European Kidney Forum on 18 June.
She recalled that the European Commission has already funded 40 projects with €64 million addressing chronic kidney diseases, and 24 projects with €47 million related to kidney transplantation.
“And with the new Horizon Europe work programme of 2021-22, there are now more possibilities for research on chronic kidney disease that include dialysis and home care,” Kyriakides added.
A key priority identified by health professionals for kidney disease treatment is the development of simpler, cheaper and more easily transportable dialysis systems.
Other potential innovations may come from blocking kidney fibrosis to arrest the progression of kidney disease, as well as from regenerative medicine with the potential of developing a working transplant kidney out of the host’s own stem cells, reducing risks of rejection.
Innovation could also make dialysis more efficient and environmentally friendly, with less water use, plastic waste, and energy consumption, to bring the treatment more in line with the general goals of the EU’s flagship environmental policy, the Green Deal.
According to Kyriakides, the ambitious EU Health Union package presented at the end of 2020 aims to put healthcare and citizens at the centre of the European Union’s policymaking.
“We will continue to support the necessary research and pooling of knowledge to increase the quality of life and life expectancy of chronic disease patients,” she said.
According to Spanish MEP Manuel Pizarro, who is also co-chair of the European Parliament’s group for kidney health, both the EU health union framework and the Horizon Europe programme mark new momentum in efforts to improve the lives of kidney disease patients.
“I have already seen a positive step forward with this programme, as it recently published a call on medical technology and devices that made specific reference to radically portable dialysis,” he said.
He added that he hopes future calls will follow groundbreaking innovation in this field, especially in preventing the progression of kidney disease.
The Horizon 2020 programme will fund the randomised controlled phase II trial of TTV GUIDE TX, which aims to optimise immunosuppressive drugs as a crucial step to minimise the risk of infection and rejection and thereby prolonging patient and graft survival.
The project, coordinated by the University of Vienna, started in May and will last for another five years, with a total budget of €6.1 million.
Another ongoing EU-funded project called EU-Train has the ambitious goal of providing medical professionals with innovative and accessible tools for early prediction of individual risk of allograft rejection and transplant loss.
The €6 million Nephstrom project conducted by the University of Galway is now in the home stretch and it is focused on the promising stromal cell therapy for diabetic kidney disease. Meanwhile the Italian-led SCOPE project on screening and prevention programmes among older people has been recently closed.
Several additional projects have been funded through the SME Instrument. Among them is Renaparin, a pharmaceutical compound used to coat the lining of the blood vessels of kidneys prior to transplantation.
More kidney-focused projects
Almost all the projects mentioned are part of the Horizon 2020 Societal Challenge 1 budgetary heading, which is one of the programmes providing funding to this research area.
There are more than 100 projects listed in Cordis, the EU research results database, filed under the keyword “kidney.”
But according to the president of Brussels-based NGO European Kidney Health Alliance (EKHA), Raymond Vanholder, these Horizon projects are not always directly kidney-oriented.
“We need more awareness of the problem [chronic kidney disease] and then this needs to be supported by financial support and research support,” he told the European kidney forum.
Vanholder called for a mechanism which would allow a comparison of the research spending for different diseases and look at what investments have been done.
“It will be very good because we know from the UK and the US that kidney disease is under-supported compared to other chronic diseases,” he said.
Indeed, a recent survey made by CenterWatch showed that investments in research from the US National Institutes of Health (NIH) amounted to $11.1 billion for cancer but only to $680 million for kidney diseases.
[Edited by Josie Le Blond]