Kidney disease inequality of “profound concern” for UK healthcare systems

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Paul Cockwell

Current inequalities in kidney disease outcomes represent a “profound concern” for the UK and must be addressed moving forward, according to UK Kidney Association (UKKA) president Paul Cockwell (Queen Elizabeth Hospital, Birmingham, UK). Speaking to Renal Interventions at this year’s UK Kidney Week (UKKW; 7–9 June, Birmingham, UK), he also discussed highlights from the event’s three-day programme, and the “criticality” of cross-speciality collaboration—another key theme observed throughout UKKW 2022.

Cockwell gave a nod to a UKKW plenary session that saw current director of the University College London (UCL) Institute of Health Equity Michael Marmot deliver “incredibly concerning” data showing worsening survival rates among UK kidney disease patients—a trend that is even more noticeable among poorer socio-economic groups and certain ethnic minorities. “These disparities are of profound concern and, of course, people with kidney disease are overrepresented in those groups,” he added.

“There has been a lot of discussion this week about what we [the UKKA] need to do as an organisation to really focus on inequalities,” Cockwell said. He noted that, following UKKW, he and a number of other people have committed to “pulling together” the various groups who care for kidney disease patients in the UK—from patient charities to research funders—to build a nationwide collaboration that can “make the case for major investment in addressing inequalities”.

Changing systems

“Another strong, unifying theme at the meeting has been the criticality of groups working together across speciality areas,” Cockwell continued, “so that we move away from ‘silo working’. In looking after people with kidney disease, we are really looking after people with a range of long-term conditions—and we need to find a way to work across speciality areas, to be able to work into primary care, and to identify people who are at risk of developing kidney disease earlier on in the pathway.”

Cockwell also stated that, when it comes to kidney disease, early intervention is vital, as it improves outcomes at an individual level, and also at a population level in terms of ensuring value for the system. “The systems are changing, particularly in England, to integrated care boards, which are responsible for delivering health and social care at a smaller population level,” he noted. “There are also changes taking place in the NHS [National Health Service] in the devolved nations as well, and what this means is that local kidney teams have to work as effectively and as accurately as possible in a really short timeframe to make the most of any new resources coming into their systems.”

UKKW highlights

Drawing out other highlights from a “fabulous” UKKW, Cockwell touched on the plenary session from Thursday 9 June, which saw UK Medicines and Healthcare products Regulatory Agency (MHRA) chief executive June Raine discuss the MHRA’s efforts to fast-track treatments through approval processes during the COVID-19 pandemic—but also, more generally, to ensure regulatory pathways are as tight as possible so that new treatments can reach patients in a timely fashion.

Having been presented as this year’s O’Donoghue Lecture, this provided a fitting tribute to the late Donal O’Donoghue and his contributions to UK renal medicine, according to Cockwell. These contributions, and O’Donoghue’s “incessant focus” on inequality and supporting multi-professional teams, Cockwell added, were also closely aligned with the core themes of UKKW 2022. Finally, he highlighted the “outstanding”, Raine Award-winning lecture given by Jennifer Lees (University of Glasgow, Glasgow, UK), which featured international competitive research that “really improves our understanding of what happens to people with kidney disease—in terms of cancer risks, how we measure kidney function, and how we map that onto a higher risk of poor outcomes, to identify those patients who really need enhanced care to protect their health in the longer term”.

The full video interview with Paul Cockwell will be available online on Renal Interventions shortly.

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