As a clinical academic, my programme of research has two broad aims:

(1) to identify, understand, and reduce kidney health inequalities, and

(2) to develop, evaluate, and implement interventions that will improve outcomes for people with kidney disease.

My interests are not limited to a single aspect of kidney disease. I prefer to apply my broad health services research training to the most important clinical questions, whether in acute kidney injury, chronic kidney disease, dialysis, or transplantation. To achieve this I work closely with epidemiologists, statisticians, trialists, qualitative researchers, health economists, ethicists, and clinicians in Bristol and around the world.

I studied medicine in Glasgow before moving to the South West for my core medical training. After gaining membership Royal College of Physicians, I moved up to Aberdeen to study for a Masters in Health Services Research and Public Health and then an MD in multicentre dialysis outcomes in Europe. With this broad training in research methods, I moved to Bristol in the late 1990s as it was the home of the UK Renal Registry and I could see lots of opportunities for combining applied research with a clinical career.

I was fortunate to be appointed the first medical director of the UK Renal Registry (2013 -2019) and during this time shifted the focus of its research, securing competitive external funding for doctoral fellows, leading two funding applications to NIHR funding for innovative registry trials (£4.6m), and supporting others secure funding for trials and evaluations involving the registry (£5.8m). I formalised links with the methodologists in Population Health Sciences at University of Bristol to work across the translational population health spectrum, using causal models to generate hypotheses for testing in trials, using qualitative methods to develop and evaluate complex interventions, and using mixed methods to optimise recruitment to trials (QuniteT Recruitment Intervention).

My main projects are:

The Prepare for Kidney Care Study – a randomised controlled trial comparing preparation for responsive management with preparation for renal dialysis in multi-morbid, frail older people with end-stage kidney disease (www.bristol.ac.uk/population-health-sciences/projects/prepare-kc-trial/). (Funded by the NIHR HTA Programme.)

The High-volume Haemodiafiltration vs High-flux Haemodialysis Registry Trial (H4RT) – a randomised controlled trial using the UKRR and linkage to other healthcare databases to provide efficient follow up (see www.bristol.ac.uk/population-health-sciences/projects/h4rt-trial/). (Funded by the NIHR HTA Programme.)

The European Quality Study (EQUAL), an international prospective cohort study looking at the optimal time to start dialysis in people over 65 years of age (www.equal-study.org). (Funded by the ERA-EDTA.)

I advise or supervise a number of clinical and non-clinical academics on a range of topics. For more details visit the Clinical Trials and Health Services Research pages Bristol Renal Research group website (https://www.bristol.ac.uk/translational-health-sciences/research/academic-renal/).

I am the Director of R&D at North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust.

Beyond the University, I have leadership and research roles at the International Society of Nephrology (honorary secretary, treasurer, lead for SharE-RR, and deputy chair of the research working group). I am associate editor of the African Journal of Nephrology and a member of the editorial board of the Clinical Journal of the American Society of Nephrology.