_{9 Aug 2012}

England’s £1.4 billion price tag for kidney disease

Kidney disease costs the NHS more than breast, lung, colon and skin cancer combined, yet too many cases remain undiagnosed and untreated, according to a report published today (6 Aug) by NHS Kidney Care.

The report, which is summarised in the medical journal Nephrology Dialysis Transplantation has found that chronic kidney disease (CKD) costs the NHS in England more than £1.4bn each year.

This is more than the combined NHS spend on breast, lung, colon and skin cancer (£1.37 billion), according to the full-length study Chronic Kidney Disease in England: The Human and Financial Cost

Treating kidney disease, including complications such as heart disease and stroke, swallows up £1 in every £77 spent by the NHS in England. 

Nearly half of this sum is spent on renal replacement therapy, yet many people are not receiving help to tackle the disease in its earlier stages when it could prevent the need for expensive dialysis or transplant.

Around 1.8m people in England have been diagnosed with CKD; however there are thought to be around a million more people with CKD who have yet to be diagnosed.  

Failure to detect these people means they also don’t get the lifestyle advice and treatment they need.  

The number of people receiving dialysis or transplant increased by 29 per cent between 2002 and 2008. Total prevalence of CKD (diagnosed and undiagnosed) is also believed to be increasing.

The report also estimated that nearly 30,000 people with CKD are not receiving essential medication to slow its progression, leading to poorer health outcomes and a massive drain on NHS resources.

The study found that half a million people with CKD were not tested in 2009-10 to see if they would benefit from ACEI (Angiotensin Converting Enzyme Inhibitor) or ARB (Angiotensin Receptor Blocker) drugs.  

Had they been, it estimates that a further 29,000 people might have been prescribed these drugs, which would improve health outcomes and save the NHS around £13m a year.

Earlier diagnosis and treatment significantly improves people’s quality of life, cuts their risk of heart attacks and stroke and minimises their likelihood of needing dialysis or transplant.  It also saves NHS resources. 

NHS Kidney Care has produced a range of resources to support healthcare professionals to improve care for people with CKD, including:

• A CKD resource pack which provides healthcare professionals in primary care with the necessary tools to identify patients with CKD, aid appropriate investigation and treatment and help patients to understand their condition and prepare for the future, including summaries of NICE guidance on CKD screening and interpreting proteinuria.
• A Royal College of General Practitioners online e-learning module on CKD to complement the resource pack and address the education needs of primary care physicians.
• The Atlas of Variation in Healthcare for People with Kidney Disease - part of Right Care’s programme of atlases – to build awareness and stimulate action to address unwarranted variation, enabling providers and commissioners to explore where they may be able to improve the quality of care they provide to kidney patients and identifying areas of good practice so that others can learn from what works well.
• A CKD Quality and Outcomes Framework (QOF) toolkit which enables practices to see their expected and reported CKD prevalence and benchmark their QOF performance against others.
• Health Investment Education Packs (HIEPs) which highlight the variation in expenditure, expenditure drivers and the outcomes for kidney disease between primary care trusts and clinical commissioning groups.

More information

• See the full news story on the NHS Kidney Care website
  
• Download:  Chronic Kidney Disease in England: The Human and Financial Cost (PDF 6.1MB)
  
• View the summary article in  Nephrology Dialysis Transplantation (PDF)