Rosie Crooks' journey from nurse to research participant in the EMPA-KIDNEY trial.

In the latter part of her career, she worked as a community Macmillan nurse, liaising with the oncology centre's research nurses. Apart from this, Rosie hadn’t had much to do with research until 5 years ago, when she was recruited onto the EMPA-KIDNEY trial in the same place she had worked as a nurse.

EMPA-KIDNEY is an international clinical trial supported by the NIHR and delivered at 51 sites in the UK, including Gloucestershire Hospitals NHS Foundation Trust. The trial aims to test whether taking a medication called empagliflozin lowers the risk of worsening kidney or heart disease in patients with kidney disease. In the UK, 1,021 participants were recruited. Half took 10mg of empagliflozin once daily, and half received a matching inactive pill, called a placebo.

"I wasn't even aware that I had chronic kidney disease (CKD)", said Rosie. "But my GP picked it up on a routine urine test and referred me to a consultant at Gloucestershire Royal Hospital, who told me I might be a suitable candidate for EMPA-KIDNEY. He introduced me to the nursing team, who went through what it would involve. I couldn't see any reason not to sign up.

"I really enjoyed meeting the nurses who carried out a thorough medical examination. Everyone was absolutely lovely. I think that was the key, that they explained everything. They knew I was a nurse, but they didn't treat me like a nurse. They explained absolutely everything and didn’t assume that I understood everything. They were also very clear in telling me that I can pull out or stop at any point.

"I saw the research nurses every month where they measured my kidney function and blood pressure, took urine samples, as well as had a really lovely chat. They took the time to get to know me and really cared.

"In the same year that I was recruited to the trial, my granddaughter was taken very ill. It was a very difficult time. I was travelling to Bristol every day for 10 weeks to see her in the hospital. The research nurse team was very supportive of me and helped to get me through that difficult period.

"During COVID, I could no longer go to my appointments at the hospital. Instead, the team would phone me and deliver the tablets. I was closely monitored, which I was very happy with."

EMPA-KIDNEY closed to recruitment sooner than originally anticipated because the team was seeing positive results.

"The study is in follow-up, so I do not know if I was on the placebo or not, but what does it matter?" Rosie said. "The doctor saw that my glomerular filtration rate (GFR), which is the main measure of kidney function, had stayed very stable during this time. They adjusted my treatment to dapagliflozin, which is in the same family as empagliflozin."

Rosie enjoyed her experience so much that when asked to be part of a second trial, she didn’t hesitate. But her albumin levels, which is an indicator of how well your liver and kidneys are working, had improved so much that she didn’t qualify for the trial.

"My message to those thinking about taking part in research is that it means you will be seen more frequently and monitored more closely. I felt it was very positive all around. I believe, not just as a nurse, that in the long run, where would we be without some research? So, I wouldn’t hesitate."