Ahead of World Kidney Day on 14th March, we’re highlighting the importance of the visibility of kidney-related illnesses, including kidney disease, and how Consultant Connect services can support healthcare professionals to provide the best care for these patients. According to Kidney Care UK, it is estimated that 1 in 10 people in the UK have kidney disease, with an average wait of two years for a new kidney. With the biggest causes of chronic kidney disease (CKD) being attributed to uncontrolled diabetes and high blood pressure, it is essential now more than ever that renal medicine advice lines are rapidly accessible throughout the UK.
Our Enhanced Advice & Guidance (A&G) service rapidly connects NHS clinicians via telephone and photo messaging so that patients receive the right care in the right place, the first time. NHS hospitals across England, Scotland, and Wales have set up Renal Medicine advice lines via Consultant Connect, utilising the rota-based system of specialists to minimise the risk of missed or unanswered queries. At the University Hospitals of North Midlands NHS Trust, in the last 12 months, 80% of calls made to the Renal Medicine A&G line were answered the first time and within 25 seconds on average. Overall, calls lasted less than four minutes, and 33% of all queries resulted in the patient avoiding an unnecessary trip to hospital*.
For NHS areas with capacity issues or no local provision, out-of-area NHS consultants on our National Consultant Network (NCN) can provide Renal Medicine A&G. The line is well-utilised, with over 1,200 calls answered in the last year within 36 seconds on average. 44% of calls resulted in the patient avoiding an unnecessary hospital visit, reducing pressures on local Secondary Care teams, and ensuring the patient received the most appropriate care plan.
Following this, we spoke with an NHS consultant nephrologist who provides advice on the NCN to find out what types of queries are received about renal medicine:
‘The majority of calls I receive from Primary Care relate to anomalies in kidney function tests (GFR), abnormally high levels of potassium, and protein or blood in patients’ urine. For patients with multiple chronic conditions, e.g., heart failure and liver disease, clinicians might have questions about how to confidently apply multiple drugs and how they interact with each other. For some parts of the UK with referral capacity issues and difficulty accessing tertiary renal care, it is much easier for the clinician to obtain nephrology advice to manage patients in the community than to refer them.
‘There are also relatively new medications available for those with CKD, such as sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are intense on the body: in the short-term, they cause a rapid decline in kidney function, e.g., for a 35% kidney function, the average rate of decline is 10% by three years. For a patient taking an SGLT2 inhibitor, it might go from 35% to 30% in two months. Then, around the 12-month mark, the kidney function stabilises, and the progression of kidney disease slows.
‘Lastly, a lot of calls are received regarding elderly patients with multiple comorbidities and an anticipated decline in kidney function. Ultimately, kidney failure won’t be their cause of death, but it might affect their quality of life, so many clinicians want advice on how to manage and treat this in the community. This benefits the patients because they don’t receive invasive therapies unlikely to extend their life expectancy, giving them a good quality of life.’
* Data from February 2023 – February 2024.
If you would like to discuss setting up a renal medicine advice line for your NHS area, please give us a call on 01865 261467 or email hello@consultantconnect.org.uk.
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