Dr Shanmugakumar Chinnappa, 34, is a clinical research fellow and nephrology registrar at the Sheffield Kidney Institute at the Northern General Hospital. With his colleagues he has recently uncovered the first clear evidence that kidney disease can cause heart failure, and is set to embark on a major follow-up study. He lives in Leeds with his wife and baby daughter. Here, he talks about his background, his research, and his top tips for other young researchers.
Tell us a bit about your background.
I grew up in India, and I studied for my MBBS medical degree in the city of Chennai, before coming to England to complete my medical training in Hull. I came to work in Sheffield four years ago.
What first got you interested in research?
I’ve always been curious and loved discovering new things, but I first became interested in clinical research specifically when I was in Hull, after reading a fascinating research paper. I knew that research improves clinical practice and I soon carried out a small study in nephrology following encouragement from my supervisor. It was onwards and upwards from there!
What does your present role involve?
I’m working in a three-year post as a clinical research fellow, supervised by Professor Meguid El Nahas in Sheffield and Prof Lip-Bun Tan and Dr Andrew Mooney in Leeds. I’m going to be working full time on research.
What’s your main research interest?
I’m particularly interested in the link between kidney disease and heart disease. Nearly 50% of kidney patients die of heart disease, so it’s really important we look into the link in much more detail. This is a fairly new area of study – it’s only really been explored over the last 10-12 years – and so I’m excited about being able to contribute some new and fresh ideas in the field.
Tell us about your latest research.
I recently had some research published in the International Journal of Cardiology with three colleagues, following a pilot study funded by the Sheffield Kidney Research Foundation (SKRF). We measured the heart’s pumping reserve (its ability to work harder during exercise or strenuous activity) in patients with kidney disease who had no existing heart condition, and compared this to that of healthy control patients.
Our results showed, for the first time, that the patients with kidney disease had reduced cardiac reserve, despite not having a heart condition per se. The most likely cause of this link is that certain toxins that are usually filtered by the kidneys remain in the body in patients with kidney disease, causing heart damage.
How do you intend to take this research further?
For the remainder of my post, I will be the Principal Investigator (PI) for a major study that will look into this link in more detail (the first time I have been a PI!). This will again be funded by the SKRF and by the Yorkshire Kidney Research Fund. At first we’ll carry the study out in Leeds. We’re going to test 120 patients this time, focussing on early stage kidney disease. This will enable us to see at what stage kidney disease starts to affect the heart, and to find out exactly what is causing the damage.
What do you hope will be the effects of your research?
I hope that it will inform future studies and ultimately improve practice. For example, we could start to give kidney patients a heart treatment called beta blockers earlier than we do now, and this could help to protect their heart muscles. We can also look at new types of dialysis, as at present dialysis is only able to remove about two thirds of the toxins that healthy kidneys can. There is plenty of research ahead!
What do you hope the future’s got in store for you?
I want to do research for the rest of my career, and combine it with successful clinical practice. I intend to be at the very forefront of research, and to use this to help patients.
What advice would you give to other young researchers?
Be proactive and approach people with your ideas – you can’t sit around waiting for them to come to you. Get involved in small projects in your department to get a taste of research. Pick a research topic, plan well in advance, and find a good supervisor. It’s also really important to get yourself into a good research environment, where there are quality researchers and facilities around you, such as we have here in Sheffield. Go to conferences to be informed and inspired. Above all, be curious and persevere.