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IAC-CKD: Improving acute cardiac care for patients with kidney disease through linkage of national audits in the UK

We are focused on improving outcomes for people with kidney and cardiovascular disease in the UK.

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This project will link for the first time national cardiovascular and kidney audits to study how we can improve acute cardiovascular treatment in people living with chronic kidney disease.


We will facilitate a novel linkage between the UK Renal Registry (UKRR) and the National Institute of Cardiovascular Outcomes Research (NICOR) audits, along with NHS Hospital Episode Statistics (HES) data to conduct a natural experiment on acute cardiovascular treatments in people with chronic kidney disease. Results from this study will directly impact current practice in the NHS and provide impetus for further studies using this multi-disease linkage. 

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This project is funded by the Health Foundation. We are a group of clinicians, epidemiologists, statisticians, and patient representatives spread across England. Data processing and analyses are taking place at the London School of Hygiene & Tropical Medicine, NICOR, and the UK Renal Registry. 

Who we are
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Our study team includes:

  • Professor Dorothea Nitsch - Professor of Clinical Epidemiology and Honorary Consultant Nephrologist, London School of Hygiene and Tropical Medicine
  • Dr David Adlam - Associate Professor in Acute and Interventional Cardiology, Honorary Consultant Cardiologist, University of Leicester (and University Hospitals Leicester)
  • Professor John Deanfield - University College London, Professor of Cardiology and Consultant Cardiologist, Barts Heart Centre (previously The Heart Hospital)
  • Dr Mark de Belder - Consultant Cardiologist, Barts Health NHS Trust and Honorary Reader University College London
  • Dr Clive Weston - Consultant Acute Physician with an interest in Cardiology; Hywel Dda University Health Board; Glangwili General Hospital, Carmarthen. Honorary Consultant within the National Institute for Cardiovascular Outcomes Research (NICOR) Barts Health, London (2018 – 2020)
  • Professor Peter Ludman - Professor of Cardiology Institute of Cardiovascular Sciences; College of Medical and Dental Science; University of Birmingham And Consultant Cardiologist Queen Elizabeth Hospital University of Birmingham
  • Mr Andrew Goodwin - Consultant Cardiothoracic Surgeon at the James Cook University Hospital, Middlesbrough
  • Professor Richard Grieve - Professor of Health Economics Methodology, London School of Hygiene and Tropical Medicine (LSHTM)
  • Dr Retha Steenkamp - Head of Operations UK Renal Registry
  • Ms Sue Lyon - Kidney Patient Representative
  • Mr Anthony Locke - Cardiovascular Patient Representative
  • Mr Patrick Bidulka - Research Assistant, London School of Hygiene and Tropical Medicine (LSHTM)
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Research is planned using linked data from Hospital Episode statistics (HES), held by NHS Digital, the National Institute for Cardiovascular Outcomes Research (NICOR), and the UK Renal Registry.

The main aim of the initial research is to document variation of care for patients who have reduced kidney function and who present with acute chest pain to a hospital. We want to quantify the risks and benefits of offering more invasive early care to patients who have a heart attack and reduced kidney function. However, as not all data on heart attacks or kidney complications are captured by NICOR we need to link data from the above data providers to better understand how care is delivered and what the outcomes were. Initial development of statistical code will use pseudonymised subsets of the data (without linkage) to prepare for analyses of the final linked dataset which will be held in a trusted research environment at NHS Digital. 

All research will take place using pseudonymised data, that means data where NHS number and other personal identifiers (such as date of birth) have been removed, and the national opt out from research has been applied. If you are considering requesting that your data not be used for this or any other research study it is recommended that you discuss this with your local GP. If you then decide that you wish to 'opt-out' of research you will need to ask your GP to mark your local record as opted out. Then no further data will be shared with us, or any other research study, but data already collected will still be processed though no future data will be collected.

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You can read more about the UK Renal Registry and the National Institute for Cardiovascular Outcomes Research (NICOR) at the following links:

UK Renal Registry