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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, Professor Jeremy Levy, Dr. Andrew Frankel, and clinical lead kidney nurse specialist Joanna Teles discuss how to effectively educate and empower patients with Chronic Kidney Disease (CKD), focusing on delivering a CKD diagnosis with clarity and reassurance, addressing common misconceptions, and encouraging patient engagement during short consultations. Joanna highlights the importance of framing discussions around âkidney healthâ rather than âkidney diseaseâ and shares practical tips for encouraging patients to take an active role in their care. Resources like the Know Your Kidneys education programme are vital tools for patient learning and support.The discussion highlights that there are practical steps to help reduce fear and unnecessary worry so that patients can be reassured and empowered. For example, it is important to explain that the term âchronicâ describes the duration of the condition rather than its severity and to clarify that CKD stages are not comparable to cancer stages. To encourage patient involvement and understanding, Joanna continues by outlining actions such as having regular âkidney health checksâ to monitor kidney function, protein levels, and blood pressure. The benefits of commonly used medications, such as Ramipril and SGLT2 inhibitors, are also explained. The conversation concludes by stressing the value of simple, actionable steps, such as keeping track of medications and bringing blood pressure readings to appointments, which can help patients feel more confident and engaged in managing their kidney health.
Top Three Takeaways:
Use clear, reassuring language to explain CKD and focus on maintaining kidney health.Promote regular "kidney health checks" and educate patients on lifestyle and medication management.Encourage small, actionable steps to increase patient engagement, such as participating in education programmes like Know Your Kidneys.Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
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)
Heart failure patients.CKD patients with or without diabetes and/or albuminuria.Patients with GFR between 20-45, regardless of urine albumin levels.
In this episode, Jeremy Levy and Andrew Frankel discuss the game-changing role of SGLT2 inhibitors in treating chronic kidney disease (CKD). These drugs, initially developed for diabetes, have shown remarkable benefits in slowing CKD progression, reducing cardiovascular risks, and delaying dialysis. They cover the key patient groups, prescribing tips, and how to use these medications safely and effectively.
Top Three Takeaways:
1. Broad Benefits Beyond Diabetes:
SGLT2 inhibitors significantly slow CKD progression, reduce cardiovascular risks, and delay the need for dialysis, benefiting patients with or without diabetes.
2. Who Should Get Them:
Avoid type 1 diabetes or "type 1-like" patients.Manage minor side effects (e.g., fungal infections) and provide "Sick Day Guidance" to minimise risks like ketoacidosis.
3. Safety and Usage Tips:This episode provides practical insights and actionable advice for clinicians managing CKD patients.
Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
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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, Jeremy Levy and Andrew Frankel discuss the role of renin-angiotensin-aldosterone system inhibitors (RAASi) in the management of chronic kidney disease (CKD), looking deeper into the mechanisms, benefits and practical considerations of using RAASi.
They cover when to initiate these medications, the importance of maximum dosing, monitoring kidney function, and managing side effects like changes in GFR and potassium levels.Key Takeaways:
RAASi Benefits Beyond Blood Pressure:These drugs lower blood pressure, slow CKD progression, and provide cardiovascular protection through mechanisms independent of blood pressure control.Maximum dosing is essential for optimal kidney and heart protection.Monitoring and Managing GFR Changes:A GFR drop of up to 25% after starting RAASi is not a cause for concern.Clinicians should reassure patients and recheck levels to ensure stability.Potassium Management:Mild to moderate increases in potassium (up to 6 mmol/L) are common and generally not an emergency.Careful monitoring, addressing potential contributing factors, and avoiding unnecessary panic are key.This episode provides practical insights and actionable advice for clinicians managing CKD patients.
Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
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 TestingFor 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 CodingConsistently 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 | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
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 of the North West London Kidney Care Podcast, Consultant Nephrologists Andrew Frankel and Jeremy Levy from Imperial College Healthcare NHS Trust discuss the diagnosis and management of chronic kidney disease (CKD) in primary care. They focus on interpreting blood test results, such as low GFR and high creatinine, and emphasise the importance of distinguishing between chronic kidney disease and acute kidney injury.The conversation also highlights the role of past blood results, urine dipstick tests, and further investigations like ACR and tests for underlying causes such as diabetes or myeloma. This episode provides practical insights for healthcare professionals managing CKD in primary care.
Key Takeaways:
Always distinguish between chronic kidney disease (CKD) and acute kidney injury by reviewing previous blood results and assessing the patient's overall health status.Don't rely solely on abnormal GFR or creatinine levels; investigate the underlying cause of CKD and consider further tests, such as urine dipstick tests and ACR, especially in patients with diabetes or hypertension.The presence of both blood and protein in the urine may indicate more serious conditions, such as glomerulonephritis, and should prompt further investigation or referral to secondary care.Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
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, nephrologists Professor Jeremy Levy and Dr Andrew Frankel, both from Imperial College Healthcare NHS Trust, explore strategies for managing Chronic Kidney Disease (CKD). The conversation focuses on essential lifestyle and health interventions to improve kidney health, particularly for patients newly diagnosed with CKD.
The hosts discuss how managing CKD should be viewed in the context of cardiovascular health. They highlight the importance of lifestyle changes, such as diet, exercise, smoking cessation, and weight management, which mirror approaches taken for cardiovascular risk.
Both emphasise the role of patient engagement and education, encouraging patients to take ownership of their health by understanding their blood pressure, glucose levels, and the long-term impacts of CKD.Blood pressure control is discussed in detail, with a focus on setting personalised targets based on factors such as age, comorbidities, and the severity of kidney disease. Frankel stresses the need for patients to self-monitor their blood pressure and understand their target ranges, typically between 120-140 systolic and less than 90 diastolic, but adjusted for albuminuria or frailty.
The episode also addresses managing diabetes in CKD patients, noting the importance of tight glucose control early in diabetes and the need to relax targets as CKD progresses to avoid hypoglycaemia.
Key takeaways include the critical role of lifestyle interventions, individualised blood pressure management, and tailored glycaemic control. Future episodes will cover specific medications and more advanced treatment strategies for CKD.
We hope you enjoyed this episode.
Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
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 our first The Rest is Kidneys episode, Dr Andrew Frankel and Prof Jeremy Levy, Consultant Nephrologists at Imperial College Healthcare NHS Trust, discuss hyperkalaemia (high potassium levels), particularly in patients with chronic kidney disease (CKD). They explore when clinicians should be concerned about elevated potassium levels, the causes behind hyperkalaemia, and the best approaches to managing it in primary care. The episode aims to demystify the condition, provide clarity on when action is necessary, and offer practical tips for managing hyperkalaemia without unnecessary panic.Key points include understanding spurious hyperkalaemia in primary care, recognising when potassium levels are truly concerning, and the role of commonly prescribed medications such as ACE inhibitors and angiotensin receptor blockers. The doctors also discuss treatment options like potassium binders and diuretics, emphasising the importance of maintaining heart and kidney-protective medications where possible. The episode also touches on the role of diet in managing potassium levels, clarifying misconceptions about potassium-rich foods and their impact.
Key Takeaways:
Spurious Hyperkalaemia: Often caused by delayed blood sample processing in primary care.
When to Act: Potassium levels above 6.5 mmol/L warrant urgent action. Levels between 5.5-6.5 mmol/L require follow-up but are not emergencies.
Medications: Certain medications, especially ACE inhibitors, ARBs, and mineralocorticoid receptor antagonists, can cause high potassium but are essential for heart and kidney health. New potassium binders, such as Lokelma and Veltassa, can help manage potassium without discontinuing these vital drugs.
Dietary Considerations: Bananas are not the only source of potassium. Many fruits and vegetables contain high levels, but stopping their consumption is not advisable. A balanced approach to diet is key.
Educational Resources: Potassium education sheets are available on the North West London CKD site.
This episode is a practical guide for primary care clinicians on managing potassium levels in CKD patients and balancing treatment urgency with patient well-being.
We hope you enjoy this episode.Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest London CKD guidelines for primary care Chronic kidney disease (nwlondonicb.nhs.uk)
Renal association: Management of hyperkalaemia in the community (algorithm) APPENDIX 5 - HYPERKALAEMIA ALGORITHM IN COMMUNITY.pdf (ukkidnThe 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub -
Send us a text
This podcast is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)
Introducing the Rest is Kidneys podcast, a new series hosted by Consultant Nephrologists at Imperial College Healthcare NHS Trust, Mr Andrew Frankel and Prof Jeremy Levy.In this trailer, clinical lead nurse Joana Teles, local GP, and ICB clinical lead for cardiovascular and renal disease Kuldir Johal discuss why this podcast has been created. The series is designed to bring healthcare professionals, especially those in primary care, the latest updates and insights into kidney health management.
Over the years, the North West London Kidney Care team, consisting of nephrologists, kidney nurse specialists, and GPs, has worked closely to improve the integration of kidney care across primary and secondary services. Now, with this podcast, the aim is to share the knowledge and experience we've gathered to support clinicians in their everyday practice.
Each episode features concise, 15-minute discussions on important topics such as the diagnosis and management of chronic kidney disease (CKD), hyperkalaemia, heart failure, and practical tips for applying local CKD guidelines. The series also highlights innovative services like the Kidney Virtual Clinic and recent improvements in funding and awareness for kidney health.
Whether youâre catching up on your commute, during a coffee break, or while out for a walk, the North West London Kidney Care podcast is a convenient way to stay informed. With contributions from experts like Prof Jeremy Levy and Prof Andrew Frankel, along with special guest appearances, each episode is packed with valuable insights to help you better manage kidney health for your patients.
We hope you enjoy listening.
Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICENorthwest 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 practitionerâs judgement.
Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub
