Khalid Mahmood: ‘A simple urine test could save lives’

Last month I was proud to host the launch of a new report from Kidney Research UK, which spells out the urgent steps the government needs to take to improve the prevention and early diagnosis of chronic kidney disease (CKD) in England. This is a subject very close to my heart as I went into kidney failure in 2008, going through dialysis before my friend, the former MEP Siôn Simon became my kidney donor.

I am by no means alone – there are nearly 7.2million people living with kidney disease in the UK and the numbers are surging, driven by an ageing population as well as risk factors including diabetes, high blood pressure and cardiovascular disease, as well as health and economic inequalities. Kidney Research UK warns that by 2033, the number of people needing dialysis to stay alive could increase from 30,000 to 143,000, taking the economic burden of kidney disease to £13.9 billion.

The consequent impact on the NHS could be disastrous, and the personal impact on human lives, devastating, as I know from experience. I spent six exhausting years on dialysis. It’s a treatment that limits your freedom and it can make you feel so sick and tired as your blood pressure plummets. I often fell over and felt extremely vulnerable.

In the end I was lucky – my friend stepped forward to donate and the operation was a success. But that’s not everyone’s story, six people a week die waiting for a kidney transplant.

Dialysis shouldn’t be the de facto solution to kidney disease. We need to stop people even getting to this stage. And it is possible.

Kidney Research UK’s report shows how we can identify and treat chronic kidney disease earlier by prioritising regular urine tests in primary care for at-risk populations. Diabetes, heart disease, high blood pressure and obesity are all risk factors for kidney disease, so we need to keep a particular eye on people with any of these conditions.

A simple urine test called the urine albumin-creatinine ratio (uACR) can show a condition called albuminuria or proteinuria, where protein leaks into the urine. If a lot of protein is leaking from your kidneys into your urine, this is a sign the kidneys are damaged.

People with a high amount of albumin in their urine are at an increased risk of having chronic kidney disease progress to kidney failure. By testing people with diabetes, heart disease, high blood pressure or obesity, we increase our chances of identifying kidney disease early and can help patients take steps to protect their kidney function through disease and lifestyle management and, sometimes, medication. This could slow progression and potentially stave off kidney failure. Some patients may benefit from treatments called SGLT2 inhibitors which can delay disease progression and reduce the risk of cardiovascular events such as a stroke or heart attack.

This type of testing ought to be part of regular disease management for people with diabetes, heart disease, high blood pressure and obesity, but NHS data shows us it is not offered routinely. To me, this makes no sense. It is relatively cheap to carry out and Kidney Research UK has shown that costs of the right interventions are offset by the savings that can be made when fewer people need expensive treatments such as dialysis.

I don’t want others to go through the same experiences as me. Government must look at how practical measures like this can be brought in. The research has been done, we have the technology, we must use it to protect kidney patients and protect the NHS.

Politics.co.uk is the UK’s leading digital-only political website, providing comprehensive coverage of UK politics. Subscribe to our daily newsletter here.