In this episode, we discuss kidney health inequalities with Professor David Wheeler, an Honorary Consultant Nephrologist and Professor of Kidney Medicine based at the Royal Free.

Professor David Wheeler would like his take-home messages to be:

1. We think there are thousands of people in the UK who have chronic kidney disease; however, they do not know they’ve got it. Many of these individuals are in socioeconomically deprived groups. We need to pick up these patients because we now have effective treatments to slow progression of kidney disease.
2. Think chronic kidney disease in the high-risk patient populations, e.g., patients with diabetes or patients with hypertension, then test these patients with a blood and urine test.
3. Understand that nephrologists want to intervene as early as possible in kidney disease patients to prevent decline in kidney health, so if in doubt, refer to a nephrologist. Many nephrologists can offer virtual consultations or advise without needing to see the patient.

Useful links

• KDIGO is a global non-profit organisation developing and implementing evidence-based clinical practice guidelines in kidney disease (last accessed May 2021).
• Kidney Research UK (last accessed May 2021).
• Kidney Health Inequalities in the UK (last accessed May 2021).

References

1. Kidney Research UK. Kidney Health Inequalities in the UK. 2019. Available at: https://kidneyresearchuk.org/wp-content/uploads/2019/09/Health_Inequalities_lay_report_FINAL_WEB_20190311.pdf (last accessed May 2021)
2. Guthrie GD, Bell S. Deprivation and kidney disease-a predictor of poor outcomes. Clin Kidney J. 2019;13(2):128-132. doi: 10.1093/ckj/sfz151.
3. Chronic kidney disease in England: the human and financial cost. Available at: https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Chronic-Kidney-Disease-in-England-The-Human-and-Financial-Cost.pdf (last accessed May 2021)
4. National Chronic Kidney Disease Audit // National Report: Part 2 December 2017. Available at: https://www.lshtm.ac.uk/media/9951 (last accessed May 2021)
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11. NICE. Chronic kidney disease in adults: assessment and management. CG182. Available at: https://www.nice.org.uk/guidance/cg182 (last accessed May 2021)
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13. Shlipak MG, et al. The case for early identification and intervention of chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2021 Jan;99(1):34-47. doi: 10.1016/j.kint.2020.10.012.
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