By Dr Stephen Coogan MBChB MRCGP, Founder and CEO, myGP Clinic
Most people know they should keep an eye on their blood pressure, cholesterol and blood sugar. Far fewer think about their kidneys — until something has already gone wrong.
That is a problem, because chronic kidney disease, often shortened to CKD, is one of the most important long-term conditions we do not talk about enough. Recent research published in The Lancet has highlighted a stark issue: a significant proportion of kidney disease remains undiagnosed, even in countries such as the UK.
Kidney Research UK estimates that around 7.2 million people in the UK are living with chronic kidney disease. Put simply, that is roughly one in seven adults. Warrington’s resident population is around 215,000, so if the national pattern is reflected locally, more than 20,000 people in Warrington may be living with some degree of kidney disease — many without knowing it. The reason is simple but dangerous. In its early stages, kidney disease usually causes no symptoms.
Patients often imagine kidney disease would cause pain in the back, urinary symptoms, or a clear sense that something is wrong. Sometimes it does. More often, it does not. A person can lose a significant amount of kidney function before feeling unwell. By the time symptoms such as tiredness, swollen ankles, breathlessness, nausea or changes in passing urine develop, the disease may already be advanced. This matters to ordinary families across Warrington and Cheshire because kidney disease is closely linked with other common conditions: high blood pressure, diabetes, obesity, cardiovascular disease and increasing age. The risk rises as we get older, and nearly one in five Warrington residents is aged 65 or over. CKD is also more common in people of Black or South Asian background.
What is often missed is that kidney disease is not just a kidney problem. Poor kidney function increases the risk of heart disease, hospital admission, complications during illness, and medication-related harm. The kidneys are central to how the body manages fluid balance, blood pressure, waste products, and many medicines. When kidney function declines, the whole person is affected.
The frustrating point is that CKD can often be detected with simple tests. A blood test can estimate kidney function, usually reported as eGFR. A urine test can look for protein leakage, often measured as an albumin-to-creatinine ratio. That urine test is particularly important because protein in the urine can be an early warning sign, sometimes before kidney function has significantly declined.
Good GP care should start with a proper history. Does the patient have diabetes, high blood pressure, heart disease, recurrent urine infections, kidney stones, autoimmune disease, or a family history of kidney disease? What medicines are they taking? Are they regularly using anti-inflammatory painkillers such as ibuprofen or naproxen? Are there changes in blood pressure, weight, swelling, tiredness or urine?
Examination also matters. Blood pressure should be measured properly. Weight, cardiovascular risk and signs of fluid retention should be considered. Investigations should include kidney blood tests and, where appropriate, urine testing for protein. At myGP Clinic, this is exactly why we believe prevention and early detection must sit alongside traditional family medicine. Modern diagnostics are useful, but only when combined with clinical judgement, continuity, and responsibility for follow-up.
For patients, the practical advice is straightforward. If you have high blood pressure, diabetes, heart disease, obesity, a family history of kidney disease, or are over 60, ask whether your kidney function and urine protein have been checked. Do not rely on symptoms. Keep blood pressure well controlled. Manage blood sugar carefully if diabetic. Avoid regular anti-inflammatory medication unless advised by a clinician. Stay active, maintain a healthy weight, stop smoking, and review long-term medicines periodically.
You should seek medical advice if you develop persistent ankle swelling, unexplained breathlessness, blood in the urine, frothy urine, worsening tiredness, nausea, poor appetite, or a change in how often you pass urine. But ideally, kidney disease should be found before symptoms appear. The lesson is not to panic. It is to be sensible. Kidney disease is common, often silent, and too often missed. A simple urine test, a blood test, and proper clinical follow-up can make a real difference. Prevention is not glamorous medicine, but it is often the medicine that protects healthspan, independence and quality of life for years to come.
