CKD Coding does not need GCHQ or Enigma machines

The Rest is Kidneys

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The Rest is Kidneys podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)
In this episode, consultant nephrologists Jeremy Levy and Andrew Frankel from Imperial College Healthcare NHS Trust are joined by Dr Kuldhir Johal, a GP and interim cardiovascular and renal lead.

Together, they discuss a critical aspect of chronic kidney disease (CKD) management in primary care: the importance of accurate coding to improve diagnosis and patient outcomes.

This episode focuses on how CKD remains underdiagnosed due to gaps in coding, confidence among healthcare providers, and primary care capacity. Dr Johal explains that CKD affects a significant portion of the population, but proper diagnosis often lags.
The discussion explores strategies to bridge this gap, like integrating albumin-to-creatinine ratio (ACR) testing into regular health checks for high-risk individuals. The speakers emphasise the collaborative tools and resources being developed to make CKD management a standard, streamlined practice in primary care.

Three Main Takeaways:
1. Early Detection through Comprehensive Testing

For patients at risk of CKD, such as those with diabetes, hypertension, or cardiovascular disease, a complete kidney health check should include both GFR (glomerular filtration rate) and ACR tests. These tests allow for early CKD detection and timely interventions to slow disease progression.
2. Accurate and Consistent Coding

Consistently coding CKD diagnoses in primary care records (with both EGFR and ACR codes) is essential for monitoring patient health, ensuring continuity of care, and ultimately improving CKD detection rates and patient outcomes.

3. Patient Involvement in Diagnosis

Engaging patients in their CKD diagnosis and educating them on kidney health empowers them to make informed decisions and adopt lifestyle adjustments that support kidney function, underscoring the value of proactive, patient-centred care.

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care Chronic kidney disease (nwlondonicb.nhs.uk)

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

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1. CKD Coding does not need GCHQ or Enigma machines (00:00:00)

2. The data suggests we are hugely under-diagnosing CKD, why might this be? (00:01:15)

3. Why is only 2% of CKD identified in North West London compared to 10% overall? (00:02:22)

4. How does adding CKD to the locally enhanced service impact patient outcomes and clinician support? (00:03:47)

5. Why there is such an emphasis on recognising early kidney disease. (00:04:56)

6. Can CKD screening be undertaken as part of of the management pathway of other diseases such as diabetes ad cardiovascular disease? (00:06:27)

7. What are the main challenges in primary care with the new coding guidance, beyond patient engagement and GP awareness? (00:08:30)

8. What other resources and support are available for clinicians with regards to CKD? (00:12:47)