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After his kidneys failed, Tugrul Irmak’s experience with dialysis made him decide to dedicate his career to improving kidney disease treatments. He has now set up the fundraiser Climb Against Time to increase awareness of the quiet suffering of kidney disease patients and the need for innovation in this field.

The burden of dialysis

In the summer of 2022, Tugrul Irmak arrived at the mountain hut after climbing the 4048 meter high Piz Bernina. That night, his life took an unexpected turn: "I got intense amounts of cramping throughout my arm, fingers and legs." This turned out to be the result of kidney failure. For ten months, Tugrul would be hooked to a dialysis machine every night. "It’s a very weird experience," he recalls. "At some point, you can’t urinate anymore, water accumulates in your body and your electrolyte balance is completely off."

People underestimate the consequences of this disease, Tugrul argues. "It’s a quiet disease. Patients go on dialysis and then slowly deteriorate over time. I was on peritoneal dialysis for 8 hours every day, which was both physiologically and psychologically very challenging. As soon as the dialysis started, I knew I never wanted to go back on that machine again."

A drive for change

His experience was a wake-up call. At the time of his kidney failure, Tugrul was a postdoc in vehicle engineering, but he switched to the field of kidney research, determined to make a difference. "I decided I wanted to do something about this. My experiences have made me necessarily ambitious. Science is difficult, it takes time and often does not go anywhere, or not where you want it to go. But for me, it has to go somewhere."

Innovation in the field of dialysis has been painfully slow, but my experiences have made me necessarily ambitious. For me, it has to go somewhere.

Quiet, slowly degenerative disease

The quiet character of kidney disease increases the struggle for progress and innovation. "There is not as much drama or sense of urgency as with some other diseases. People slowly degenerate over time and are forgotten." Because of this, the seriousness of the disease is underestimated, Tugrul argues: "The average life expectancy of a 36 year-old on dialysis has only slightly improved over the past 20 years, from about 8 to 12 more years. It makes you think: if you have kids, do you see them grow up?"

The minor improvement in life expectancy is mainly the result of better medications to treat comorbidities than improvements in dialysis technology. "Dialysis treatments have largely remained unchanged. Comparing footage of a dialysis ward from the 1970s and now, it looks exactly the same. Despite the billions of euros spent annually on treatment, innovation in this field has been painfully slow."

Towards a bioengineered implant

This lack of progress strengthened Tugrul’s motivation to take action. His research group at the UMC Utrecht, led by dr. Karin Gerritsen and where he works as a postdoctoral researcher, has an ambitious vision: a technological pipeline that goes from an implantable dialyser to an implantable bioartificial kidney and ultimately a bioengineered implant. "Until recently, I don’t think that people have seriously tried to make a big change. But now, with technologies like 3D-printing, we have tools and possibilities that did not exist before."

Climb Against Time: a call to action

Recently, Tugrul launched his initiative  in collaboration with , an idea that was born shortly after he received his kidney transplant from his mother. Two weeks after his transplant, he walked past the National Donor Monument in Naarden, called ‘The Climb’. It reminded him of his passion for mountaineering and the struggles he experienced during dialysis. He decided to use this as a symbol for his initiative.

Climb Against Time invites people to take on a personal challenge to bring attention to the urgent need for dialysis innovation. While the fundraiser does aim to raise money for research, that is not its primary goal: "I want to highlight the innovation roadblock. We need change." As his personal challenge, Tugrul has decided to climb 41 peaks over 4000 meters in the Alps through committing, technical routes. "For such routes, the only way out is up."

Tugrul emphasizes that everyone can contribute: "Do your own climb. It does not have to be a literal mountain, it can be anything that challenges you. Even if you don’t want to participate, maybe you know someone who is a bit of a nutter who does," he jokes. "The more people get involved, the more we can make a change."

The future of kidney failure treatment

Tugrul believes that change is coming, but is only possible if society and researchers come together to support the cause. Through Climb Against Time, Tugrul hopes to change the conversation around dialysis. "We need to create a momentum to develop real solutions. We need something outside of the current paradigm," he insists. "We can’t just accept that dialysis is a life sentence."