Evidence map›Paper›PMID 41904445›Full record

ArticleBMC nephrology2026

The UK Eastern Network for Kidney Inflammatory Disease (ENKID) MDT at 24 months: advancing access to high-cost drugs, clinical trials, and complex case management in renal autoimmune diseases.

Lucy Francis, Olivia Kanka, Ondrej Suchanek, Lisa C Willcocks, Kevin W Loudon, Clare Morlidge, Barbara Thompson, David C Thomas, July Da Silva Araujo, Bernadette Laforteza and 7 more

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Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Lucy FrancisDepartment of Medicine, University of Cambridge, Cambridge, UK. lucy.francis19@nhs.net.
Olivia KankaAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Ondrej SuchanekAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Lisa C WillcocksAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Kevin W LoudonDepartment of Medicine, University of Cambridge, Cambridge, UK.
Clare MorlidgeEast and North Hertfordshire NHS Teaching Trust, Stevenage, UK.
Barbara ThompsonEast and North Hertfordshire NHS Teaching Trust, Stevenage, UK.
David C ThomasDepartment of Medicine, University of Cambridge, Cambridge, UK.
July Da Silva AraujoAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Bernadette LafortezaAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Praveen JeevaratnamEast and North Hertfordshire NHS Teaching Trust, Stevenage, UK.
Sapna TrivediAddenbrooke's Vasculitis and Lupus Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Frances C HallDepartment of Medicine, University of Cambridge, Cambridge, UK.
David R W JayneDepartment of Medicine, University of Cambridge, Cambridge, UK.
Rona M SmithDepartment of Medicine, University of Cambridge, Cambridge, UK.
Rachel B JonesDepartment of Medicine, University of Cambridge, Cambridge, UK.
ENKID

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGlomerulonephritis (GN) accounts for 20%–25% of the causes of chronic and end-stage kidney disease. The evolving treatment landscape with new targeted immunosuppressants has highlighted the unmet need for equity of access to specialist GN services. Regional networks and multidisciplinary team meetings (MDTs) provide access to clinical expertise, high-cost drugs (HCDs) and clinical trials, facilitating collaborative decision-making and optimal use of therapeutics to improve patient outcomes. Launched in May 2023 in the East of England (EoE), the Eastern Network Kidney Inflammatory Disease MDT (ENKID) provides a regional MDT framework designed to improve access to specialist expertise and HCDs- areas identified as lacking for 59% of nephrologists in a 2024 UK GN service survey.

methodsENKID is led by the specialist vasculitis, lupus and primary GN service in Cambridge. A database build allows secure standardised data collection including referral indications and treatment decisions during fortnightly virtual regional MDTs.

resultsOver 24 months, 229 discussions were conducted for 198 patients in 43 ENKID MDTs, averaging 15 attendees from 6 centres per meeting. Patients were referred for both clinical complexity and HCD use in 46% (n = 106), solely HCD access in 42% (n = 96) and for clinical complexity alone in 12% (n = 27). Clinical trial eligibility was an additional reason in 9% (n = 20). Diagnoses discussed were ANCA-associated vasculitis (33%, n = 65), membranous nephropathy (18%, n = 35), IgA nephropathy (19%, n = 38), lupus nephritis (15%, n = 29), minimal change disease/focal segmental glomerulosclerosis (7%, n = 14), rarer diseases (5%, n = 10) and diagnostic uncertainty (3%, n = 7). Including rituximab, a HCD was endorsed in 71% and alternative treatment recommended in 29% of referrals for HCD discussions. A wide geographical distribution of referrals was observed and facilitated widespread access to HCDs.

conclusionsThe ENKID regional MDT addresses the increasing demand for specialist advice for patients with complex and rare kidney diseases. High attendance and case load underscore the need for this service, aligning with the UK government’s mandate for rare autoimmune disease. Integration of this MDT within the EoE NHS England renal network structure, providing governance, education and HCD access, serves as an exemplar for improving GN patient care and accessibility of UK services. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Autoimmune DiseasesGlomerulonephritisHealth Services AccessibilityImmunosuppressive AgentsPatient Care TeamAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisClinical Trials as TopicFemaleGlomerulonephritis, MembranousHumansLupus NephritisUnited KingdomImmunosuppressive AgentsAutoimmune renal diseaseGlomerulonephritisHigh-cost drugsNephrology servicesRare diseaseRegional multidisciplinary team meetings

Identifiers

PMID41904445
PMCPMC13151189

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.