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Renal services

The Royal Free’s nephrology and transplantation department serves a local population of 1.4million people, providing a comprehensive in-patient and out-patient service for the investigation and treatment of kidney problems. It is also nationally recognised in a number of sub-specialty areas.

The Royal Free is a major transplantation centre and carries out 110 kidney transplants every year of which around 40% are from living donors. Offering keyhole surgery (laparoscopic) as routine, its results compare favourably with the best transplant units both nationally and internationally. The department has special expertise in arranging live donor transplantation from donors who live abroad. It also manages dialysis services for the north central London area, with all modalities supported and an active dialysis research programme.

The department is a regional centre of excellence for vascular access surgery for haemodialysis and has a specialist service for acute kidney injury.

Other services offered by the renal team include:

  • General nephrology services
    • chronic kidney disease management
    • hypertension (high blood pressure)
    • low clearance (pre-dialysis) care
  • Specialist clinics
    • autoimmune diseases: systemic lupus erythematosus and scleroderma
    • vasculitis (disorders causing inflammation of the blood vessels)
    • nephrotic syndrome/glomerular diseases (disorders of the kidney’s ‘filters’ causing protein leakage)
    • renovascular disease (narrowing or blockage of the renal arteries)
    • Fabry’s disease (in conjunction with the Royal Free's lysosomal storage disorders unit)
    • amyloidosis (the Royal Free is home to the UK’s national amyloidosis centre)
    • genetic renal disease (coupled with a research programme)
    • renal tubular disease (diagnosis and management of complex fluid and electrolyte abnormalities)
    • metabolic kidney stone service (diagnosis and prevention of underlying causes of kidney stone formation)
    • renal-HIV disease clinic (in conjunction with the HIV disease specialists)
  • Interventional radiology
    • tunnelled central venous catheter placement (for haemodialysis)
    • fistuloplasty (procedure for re-opening blocked or narrowed haemodialysis access)
    • superior vena cava venoplasty (procedure for re-opening blockages of the large veins)

Metabolic kidney stone service

The Royal Free metabolic kidney stone service is one of just a few units in the UK to specialise in the medical management of recurrent kidney stones. We are distinctive in having very close links with our stone urologists, allowing us to provide a complete and integrated service to our patients with kidney stone disease. The Royal Free has one of the largest such programmes in the UK and has a great deal of clinical and research expertise in this area.

Kidney stones are an increasingly common problem worldwide and can require frequent shock-wave (lithotripsy) or surgical treatment. Recurrent kidney stones have a negative impact on a patient’s quality of life. They can also lead to more severe health problems such as kidney failure.

The Royal Free’s unit specialises in diagnosing the underlying causes of recurrent kidney stones. These causes may be genetic, metabolic, anatomical, biochemical or due to a patient’s diet. We conduct a range of blood and urine tests to identify the causes, in conjunction with specialist laboratory expertise at the Royal Free. Patients can then receive the most appropriate treatment to improve the problem and in some cases, stop them from developing kidney stones altogether.

The unit is also a centre of stone research, focusing on improving understanding of the genetic, dietary and biochemical causes of kidney stones.

Staff:
Professor Robert Unwin, consultant nephrologist and professor of nephrology
Dr Shabbir Moochhala, consultant nephrologist