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Kidney Health 2021

Pandemic worsens inequalities in kidney care

Dr Graham Lipkin

President, UK Kidney Association

Dr Sharlene Greenwood

President, UK Kidney Association

The severe impact of COVID-19 on the kidney community and the results of growing health inequalities have highlighted the need for decisive action to improve care.

We have witnessed the impact of COVID-19 first-hand and how the pandemic disproportionately affected marginalised populations, aggravating existing inequalities for patients with kidney disease. Rallying together as a community, we have been provided with a strong voice, innovation, expert support and steps for improvement at a time of crisis.

Health inequalities

Kidney disease disproportionately impacts patients from ethnic minorities and those with socio-economic deprivation. The incidence of chronic kidney disease is three to five times higher in those of South Asian or African-Caribbean origin.

This has led to a greater number of these patients reaching advanced kidney failure. The reasons include a higher incidence of high blood pressure and diabetes in these groups, a genetic predisposition in some and a higher rate of inflammatory diseases.

Tragically, it is these same patients who suffered most from COVID-19. Patients with kidney disease, particularly those treated by dialysis or transplantation, have suffered a high incidence of COVID-19 infection. In fact, most patients receiving dialysis attend hospital or dialysis units three times each week and were unable to shield. This dialysis population suffered the highest mortality of all the clinically extremely vulnerable groups within the UK. Kidney transplantation had to be suspended in many parts of the UK. This served to intensify existing inequalities in access to treatment and care.

Most patients receiving dialysis attend hospital or dialysis units three times each week and were unable to shield.

Getting It Right First Time

Whilst there is much work to be done to address these inequalities, awareness in these communities and the need to check for blood pressure, diabetes and those with a family history of kidney disease have improved.

Improvements involve screening, lifestyle advice, effective blood pressure treatment, monitoring of kidney function with blood tests and ensuring access to novel drug therapies. Quality improvement initiatives of NHS England, ‘Getting it Right First Time’ and the Renal Service Transformation, programmes include strategies to address prevention and measures to deal with inequities in access to the best treatments.

The Renal Association and British Renal Society have collaborated closely over the past year to produce extensive expert guidance and support for prevention and management of COVID-19 in patients with kidney disease. The success of this collaboration has heralded the creation of a new joint professional structure of doctors, allied health professionals and scientists, the UK Kidney Association. Closer working as a single, national organisation will achieve a ‘stronger together’ outcome. 

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