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Disease insight reports

Costed Integrated Patient Scenario: Chronic Kidney Disease

NHS nephrology services are responsible for managing people with kidney failure which may occur as a result of chronic kidney disease (CKD) or acute kidney injury (AKI). Around 3 million people in the UK today have CKD with uncontrolled diabetes and high blood pressure the biggest causes of CKD.

This report provides clarity on the issues faced in managing CKD when dialysis has to be the modality of choice by bringing the scenarios to life in a very realistic way.

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With around 3 million people in the UK with CKD and 63,000 of these being treated for stage 5 CKD , proactive management of CKD progression to renal failure from earlier identification and management within primary care is paramount to improve the overall experience of [any] related acute admission [or potentially eliminate the need] and optimise after care and the overarching clinical pathway costs.

However, there is evidence of huge variation in the recognition and care management of kidney failure across the country and the need for focused improvements cannot be overestimated. Working in partnership with Baxter Healthcare Limited, Wilmington Healthcare Consulting developed a fictional – but robust Costed Integrated Patient Scenario (CIPS) in order to fully evaluate the existing range of dialysis options for people with progressive CKD not eligible for transplant.

The objective
To enable clear identification of the key health and social care components that would comprise an optimal best practice pathway through a full comparison of planned proactive versus unplanned reactive renal replacement therapy (RRT).

The outcome
This CIPS report, first launched at UK Kidney Week 2020, identifies early intervention in primary care during the ‘critical referral window’ within the optimal scenario is the opportunity to improve health outcomes, quality of life and reduce the overall cost of [acute] care. Identifying all elements of the patient journey could enable greater investment earlier in the patient journey and ensure personal choice of modality for RRT therapy is always considered – particularly as regional decisions to transform care pathways begin to acquire a integrated population focused view of costs and improvement over the medium-term.

Download the full report.