Report reveals 43% of chronic kidney disease cases go undiagnosed

A population-level analysis found 43 per cent of chronic kidney disease cases in Greater Manchester are currently undiagnosed.

The analysis estimates that around 94,000 people in the region have chronic kidney disease (CKD) without a diagnosis. Most are of working age and in the early stages of the condition.

It also found substantial differences linked to deprivation. People in the most deprived areas wait nearly three years from clinical evidence of CKD to diagnosis, compared with one year in the least deprived areas.

The analysis was produced by Carnall Farrar (CF) and Health Innovation Manchester and examined the cardiovascular impact of CKD across Greater Manchester.

It combined national Hospital Episode Statistics and CVDPrevent audit data with a linked primary and secondary care dataset covering 209,328 patients with CKD.

Ben Richardson, managing partner at CF, said: “Chronic kidney disease is one of the largest preventable contributors to cardiovascular harm in England, yet it stays largely invisible in how we plan and commission care.

“By linking primary and secondary care data across Greater Manchester, we can see the scale of the undiagnosed population and the size of the opportunity.”

According to the report, people with CKD face a six-fold higher risk of major cardiovascular events.

Patients from the most deprived areas account for more than 50 per cent of people receiving dialysis, despite representing 20 per cent of the population.

The analysis also looked at the financial impact of the disease. Annual NHS costs were estimated to rise from £352 per person at stage 1 CKD to £21,794 at stage 5.

The total cost associated with Greater Manchester’s diagnosed CKD population was £329m in 2023 and is projected to reach £381m by 2033 without intervention.

The report calculated that earlier identification and treatment of CKD at stages 2 to 5 would require around £23m in additional annual prescription spending across Greater Manchester.

It estimated this could generate £45.7m a year in savings through reduced secondary care admissions and avoided dialysis and kidney transplant costs, producing a net saving of £22.7m.

The analysis also estimated that more than 2,100 cardiovascular events and 265 deaths could be prevented each year.

The findings are driving the Circulation Health project, involving Health Innovation Manchester, Boehringer Ingelheim and the Greater Manchester Primary Care Provider Board.

The initiative has identified approximately 18,000 eligible patients with multiple cardiovascular-renal-metabolic conditions who are not receiving comprehensive, guideline-aligned care.

It will enable up to 64,800 neighbourhood-led clinical interactions across 20 Primary Care Networks, creating capacity to deliver holistic interventions and reduce health inequalities at scale.

Laura Rooney, deputy chief executive at Health Innovation Manchester, said: “CKD too often goes undetected until it has already had a significant impact on people’s lives.

“The publication of the CVD MSF highlights the growing national recognition that cardiovascular, kidney and metabolic conditions cannot be tackled in isolation, and this analysis brings into focus the real opportunity to change outcomes for patients across Greater Manchester – supporting earlier diagnosis, improving access to effective treatments, and ultimately preventing avoidable cardiovascular harm.

“At Health Innovation Manchester, our role is to bring partners together, across the NHS, academia and industry, to turn this kind of insight into practical action so innovation reaches patients sooner and helps deliver more equitable, preventive care at scale.”

Fiona Loud, policy director at Kidney Care UK, said: “This evidence presents a compelling case for change and now is the time to make that change.

“With almost half of people with kidney disease in Greater Manchester not knowing that they have it, the region has the chance to change those lives for the better, leading the way to better early identification and treatment.

“Time and time again people with kidney disease tell us that they wish they had been told about their condition and given advice about what could be done sooner.

“Not only will this improve their quality of life, but it will also have an economic impact too.