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Prof Lesley Rees
Renal office
Gt Ormond St Hospital for Children NHS Trust
London
WC1N3JH
Tel: 02074059200
Fax: 2078298841
Prof Lesley Rees profile picture
Appointment
  • Emeritus Professor
  • Developmental Biology & Cancer Dept
  • UCL GOS Institute of Child Health
  • Faculty of Pop Health Sciences
Research Summary
Improvements in medical technology have led to the ability to treat even the youngest children with chronic kidney disease (CKD) with dialysis and transplantation. However, many children suffer from handicaps due to poor growth and renal bone disease. In addition, young adults have a risk of death from cardiovascular disease (CVD) equivalent to an 85 year old. The main focus of my research has been to investigate these three most significant, and inter-related, complications. My key objectives are to reduce morbidity by improving understanding of the causes and to identify preventative measures or treatments. This work has been conducted using clinical, basic science and translational research.

1) Growth in CKD
Poor growth in association with CKD is common, and may be due to endocrinological, nutritional and biochemical abnormalities. I have systematically investigated the roles of each cause. I hypothesised that the hypothalamo-pituitary-growth hormone axis might be contributory. My investigations demonstrated abnormal nocturnal pulsatile secretion of growth hormone and its mediators in children with CKD and in those taking steroid therapy. This led me to hypothesise that growth hormone might be an effective treatment, so I conducted the first trial of growth hormone therapy in CKD and post transplant. I showed it to be efficacious and safe in the short term. However, at follow-up of these patients 10 years later, I was unable to demonstrate a long-term benefit. This directed me to study the impact of intensive nutrition. I led retrospective reviews of the growth of our patients and showed that nutrition is the most important factor in the prevention of growth failure in CKD; our unit is recognised worldwide for our feeding programmes.

2) Renal bone disease
Renal bone disease is a cause of poor growth and also pain and deformity.
Teaching Summary

MD student projects (principal supervisor, all students have passed)

1. 'Factors predisposing to arterial disease in children with chronic renal failure', 1999, University of London
2. 'Growth in renal disease', 2001, University of Edinburgh
3.'A study of the mechanisms of action of growth hormone therapy in renal disease', 2004, University of London
4.'A study of renal osteodystrophy', 2004, University of London
5.'A study of treatments for endothelial dysfunction in chronic renal failure', 2004, University of London


Current MD student:
'Mechanisms, clinical consequences and treatment of intradialytic hypotension' to submit this year

Principal supervisor for successful PhD 'Vascular calcification and its relationship to renal osteodystrophy', University of London, 2008

Since 1990, with consultant colleagues, I have organised the annual week's course on topics in paediatric nephrology at The Institute of Child Health. The course is intended to offer up-to-date information on developments in paediatric nephrology and urology to an international audience of Paediatric Nephrologists and Urologists.

In 1996 I established an annual study day on 'Paediatric Nephrology for General Paediatricians', at the ICH, attended by approximately 100 from the UK and abroad.

I have been part of scientific organising committees, reviewed abstracts and have chaired sessions for international nephrology meetings. I have been on the editorial board of two journals, and am currently on one. I have written 18 book chapters and I am senior author of a 'Handbook of Paediatric Nephrology' (Oxford University Press), which has been adopted as the protocol book in nephrology and has sold worldwide (>1500 copies).I have given 50 international invited lectures.

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