In 2011 Mark was appointed to a post as Consultant Nephrologist at the University Hospitals of North Midlands and has since completed a PhD at Keele University, supervised by Prof Simon Davies. This has been an investigation of the link between peritoneal membrane function and the activation of cytokine networks both systemically and locally within the peritoneal cavity especially in the context of the progressive membrane injury associated acquired ultrafiltration failure that precedes EPS.
2002 – 2011 West Midland Deanery Renal Medicine Training Program
2006 Renal Advanced Trainee, Christchurch Public Hospital, New Zealand
2008 – 2010 Clinical Research Fellow, Keele University and University Hospital of North Staffordshire
Research and scholarship
Mark's current research is an investigation of the link between peritoneal membrane function and the activation of cytokine networks both systemically and locally within the peritoneal cavity especially in the context of the progressive membrane injury associated acquired ultrafiltration failure that precedes EPS.
Mark has already published the longitudinal membrane changes that precede the development of EPS, emphasising the reduction is osmotic conductance that appears to be the key discriminator, suing single centre data from the Stoke PD study. He has been working with the GLOBAL Fluid Study data set to determine the relationship between dialysate IL-6, membrane function and local pathway cytokine activation. This analysis (currently awaiting approval of the GLOBAL investigators for submission), clarifies that the strongest known determinant, after centre effect, of transport status is the local IL-6 production (as opposed to systemic levels) and that this is associated with the activation of intraperitoneal inflammatory cytokines. This clarifies that the peritoneal cavity can be regarded as a potentially inflammatory environment distinct from the systemic inflammation often seen in CKD5 patients and more closely associated with their comorbidity status. His research has enabled him to gain the skills required to work with large cohort studies such as the Stoke PD Study and the GLOBAL fluid study. These include data quality management, in particular using PDDB, the bespoke clinical research tool developed by Keele and Cardiff to manage a number of PD studies and data analysis methodology – for example the use of multilevel modelling to undertake multivariate regression using ML-Win and SPSS. In parallel with the PhD Mark is also undertaking a Diploma in Medical Statistics.
Mark has also been a member of the research team undertaking biomarker discovery work with colleagues in Manchester, Sheffield and Cardiff, including the metabolomics and proteomics studies, with the responsibility for identifying from the databases patients with the correct phenotypes for inclusion in the nested case control studies. They have also applied their cytokine studies to these longitudinal cases finding, as reported by the Amsterdam group that there is a tendency for patients who subsequently get EPS to have relatively high IL-6 dialysate levels, in keeping with their tendency to develop increasingly high solute transport with time on treatment, but that this is not a strong discriminator between those developing EPS/reduced osmotic conductance and those with stable ultrafiltration.
- West Midlands STC registrar representative 2007-11,
- regular medical student and junior doctor teaching
- initiated a national quality improvement in nephrology training programme.