Tag Archives: marsden fund

Happy WKD

I love living in NZ, it enables me to be the first in the world to wish everyone a happy World Kidney Day.  May your kidneys never lack oxygen, be always filtering, and ever distant from the nephrologists biopsy needle!

Let me remind you:

 If it weren’t for your kidneys where would you be

You’d be in the hospital or mortuary

If you didn’t have functioning kidneys

(with apologies to John Clarke)

Better, take a look at this video too (from www.worldkidneyday.org):

This year’s theme for World Kidney Day is “Kidneys for Life: Stop Kidney Attack.”  If you’ve not caught up with my myriad of other posts, Kidney Attack (aka Acute Kidney Injury) is the rapid loss of kidney function and/or structural damage brought about by toxic damage to the kidneys or temporary loss of blood to the kidneys.

This week I published a blank post entitled “A list of effective treatments for Kidney Attack.”  There is no known treatment – merely acute dialysis, a support for the kidneys, not a treatment. There is no treatment because detection is delayed and difficult and because not enough research has been done.

The good news is that I and many others around the world are engaged in finding new ways of detecting this disease.  Before I list some of the good news I want you all to repeat after me “30,000 kidney attacks a year in New Zealand, 1300 deaths.”  If you live out of New Zealand you may say “Two million die of Kidney Attack each year.”  Now tell someone else … anyone … the next person you see (not your boss if you read this at work).  Well done, thank you.

So, for some good news:

Hooray – we have for the first time means of measuring structural damage to the kidneys.  For us, this is the X-ray moment.  Imagine life before the X-ray – all that could be said is that you could no longer bowl a bouncer (throw a curve ball), play the piano, or dance a jig (whatever that is).  In other words, all that could be said was function was lost.  With the X-ray actual injury to the bone could be observed.  Importantly, it could be observed before function was lost permanently.  The measurement of various molecules we make in the urine are to us like the X-ray – they are measures of injury to the kidney (we call them biomarkers).

We are busy investigating how best to use these biomarkers and have been discovering:

  • which are best after Cardiac surgery, Contrast procedures or in the ICU (all risk factors for Kidney Attack),
  • what the optimal timing is for measurement of each biomarker,
  • how to use the biomarkers in Randomised Controlled Trials aimed at testing new treatments,
  • which biomarkers are best for detecting Kidney Attack when someone has additional co-morbidities like sepsis, and
  • which biomarkers add the most value to what we already know and enable the best assessment of risk of poor outcomes.

In the meantime, some of my work has shown how we can better utilise the information we already have with urine output and the mainstay of nephrology, the plasma creatinine measure:

  • the discovery that even when creatinine does not change after Cardiac Arrest there is likely to be Kidney Attack (it had been thought that it was only when creatinine was elevated there was a problem),
  • a combined measurement of plasma & urine creatinine and urine flow rate (called creatinine clearance) over a short period of time in the ICU helps identify Kidney Attack patients otherwise missed,
  • how best to estimate someone’s “normal renal function” so that a judgment can be made if it has recently changed, and
  • how best to utilise creatinine in Randomised Controlled Trials to tell if an intervention is improving kidney function.

All these add up to progress.  My own and my group’s work over the last 6 years has received funding from a number of funders (see logos attached) some of which originate with your tax dollar – hence my commitment to keep the tax payers informed. I am indebted to my boss, Professor Zoltan Endre, not only did her hire me (I think he mistook Physicist to mean Physician!), he has taught me heaps and consequently we have formed a strong collaboration. Our work has also depended on the good staff of Dunedin and Christchurch Hospital ICU’s, Christchurch Emergency Department, and the Canterbury Health Laboratories.  Without the commitment to research these people make, progress would not have been made.  Most important are the patients or their families who have consented for us to take extra samples or enroll them in a trial. The decision to participate is often made at a difficult time – families wrestling with issues of possible death or long term health issues of their loved ones.  I salute them.  I thank them.  New hope, new medicines, new tests, and new procedures are built on the courage and generosity of the patients and families who participate in research.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.

Sponsors who have provided grants (top row), or run assays (middle row), or provided free accommodation (me!) for the Christchurch Kidney Research Group, University of Otago.

$6,126,820

$6,126,820 has been sitting on my fridge for the last two years. I aim to raise this over 20 years so as to continue my research.  Yes – I confess, I am the Six million dollar man (Historical reference for those over 40).  Sounds a lot of money, but let’s put this in context.  Because I am “research only” staff, I must raise all my salary and expenses, so the calculation was the sum of my salary, a salary for a part-time research assistant (2 days a week), overheads on both our salaries at a rate of 108% (the rate my university expects from me) and about $20,000 a year for a few research expenses.  In other words, about $300,000 p.a.

A few comparisons from government funding

Teacher: $164,000 p.a.   New Zealand spends about $7000 per secondary school pupil.  Apparently there are 23.5 pupils per year 9 student.

 Olympic athlete:  $150,000 p.a.  According to Prime TV, the NZ government spent $108,000,000 sending ~180 athletes to the current Olympics.  Assuming this was spread over 4 years, then this is about $150,000 p.a per athlete.  Of course, many also have corporate sponsorship.

I wonder what a mid level manager with a part-time secretary in the ministry of housing costs?  I can well imagine it passing $300,000.

The Six Million Dollar Fridge

The Six Million Dollar Fridge

Is what I do worth two athlete’s olympic performance?  Is it worth more than an average year nine teacher.  Perhaps not for me to say. This is not to say the government should not put money into the athletes or teachers, merely to point out that if I were to raise the money from government science funding such as the HRC or Marsden, then this would be my relative value to NZ according to the politicians who divide up the budget.  The reality is that I am very unlikely to raise this money from government sources.  In the last two years I have raised about $420,000 dollars of which $300,000 is from governement funds via the Marsden fund (thank you) and a little from the University of Otago Research Grants. The rest is from the Australia and New Zealand Society of Nephrologists. Unfortunately, it is about $200,000 under budget, so I no longer have a research assistant (she was very good and is sadly missed). If I were to reach my goal via governement funding I will need to get a gold medal (an HRC grant or Marsden grant) every two to three years.  As these have success rates of about 7 and 12% respectively, this is a very big ask.  So, how shall I raise the dollars?

The Plan

First and foremost I shall continue to put the bulk of my time into being the best scientist I can, otherwise there is no point! My skills are in science not fund raising.

Second, and despite what I just said, I shall look for innovative ways to raise money.  Siouxsie Wiles sojourn into the world of crowd source funding was inspiring, if not a little daunting. Perhaps this sort of innovation on a larger scale?  For that I need to find the right people – entrepreneurs and fund raises who will help me find the people looking to donate to a good cause.  Maybe I will write Apps or ebooks? No stone shall be left unturned.

Third, expand my connections to other research groups here and overseas.  I’ve already begun this – I now have an honorary position with UNSW in Sydney.  So far, no money has come with the extra work, but it is worthwhile work and I certainly would like to contribute to more such projects.  As I am a data analysis person the mantra is –give me your data and I shall massage it into a story worth telling.

Fourth, corporate sponsorship.  Yes, I will wear their jacket and paint my car if they so desire.  In medicine corporate funding is a tricky business.  It is important not to be seen to be biased.  As I am not a medical doctor, I have the advantage that any sponsorship could not influence my clinical practice (I don’t think it does for most medical people anyway). However, because I am not a medic, pharmaceutical companies and the like are probably less likely to sponsor me. But if I don’t ask I won’t know!  So far I have had a good relationship with three biomarker companies who have measured specific protein concentrations for myself and my colleagues using their own assays – no strings attached.  Essentially, I contribute to their knowledge base and they contribute to my research.  Unfortunately, there is no cash flowing for salaries yet.

Fifth, I shall remind the university that my contribution to their PBRF funding is substantial and some kind of retainer wouldn’t go amiss.

Sixth, I shall continue to talk with politicians about the lack of public funding for science.  I began this in 2008 and have had several good discussions.

Finally, I shall not totally give up on grants just yet, but I shall be judicious about which ones I spend time applying for.