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How to develop and maintain a role in renal health

Publication date: 06 November 2025

Reviewing core knowledge

Revise existing knowledge and skills including current knowledge and experience of the existing guidelines for the management of acute kidney injury (AKI), Chronic Kidney Disease (CKD), cardiovascular risk and diabetes management.

Consider national and international guidelines in the approach to patients, including:

  • National Institute for Clinical Excellence (NICE) - Chronic Kidney Disease, Hypertension, Heart Failure, Lipid and Diabetes guidelines
  • UK Kidney Association
  • Scottish Medicines Consortium guidance (Scotland)

Finding a mentor

GPs should consider approaching their local renal unit(s) to find a clinician to support them.  If needed, the UKKA may be able to provide contact(s) for GPs seeking a renal health mentor to their local renal unit. The RCGP mentoring platform also has GPs willing to support colleagues in developing into this role.

Gaining additional theoretical knowledge

Renal health can be broadly divided into areas: underlying principles, Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), Cardiovascular-renal-metabolic (CVRM) and research to support GPs develop and increase their knowledge base in renal health.

Underlying principles - lists of learning and resources covering the fundamentals of renal health

  • UKKA Education Hub - UK Kidney Association (UKKA) has a wide range of resources on kidney diseases, care, and quality improvement; materials on chronic kidney disease, acute kidney injury, rare kidney conditions, and more.
  • HCP Resources (Kidney Research UK) - Kidney Research UK has resources for primary care healthcare professionals to support patients living with multiple long-term conditions and help them to spot kidney disease sooner or slow the progression of chronic kidney disease.
  • Kidney disease: A UK public health emergency (Kidney Research UK) - Kidney Research UK commissioned ZS Associates to prepare an independent report on the health economics of kidney disease and associated factors in the UK in 2022. The report includes modelling of some illustrative interventions for adults with chronic kidney disease, risk factors associated with chronic kidney disease and changes in the health economic burden of treatment of kidney disease over the next ten years.
  • Kidney health inequalities (Kidney Research UK) - This 2024 report brings together evidence from people affected by kidney disease, health professionals and researchers. It sets out recommendations for the research community and priorities by patients, to move towards equitable kidney health for all.
  • Time To Act: A New Review of Kidney Health Inequalities (External PDF) - This five-year review, led by an academic and clinical team working with patients, sets out revised recommendations that continue to inform researchers, health-policy makers, healthcare professionals and funders, of the ongoing challenges that limit kidney health being a reality for all.
  • Shared decision making (NICE) - This guideline covers how to make shared decision-making part of everyday care in all healthcare settings. It promotes ways for healthcare professionals and people using services to work together to make decisions about treatment and care.
  • Article: The dialysis timebomb: Why preventing kidney disease is everyone’s responsibility (External PDF)

Acute Kidney Injury (AKI) learning

  • Acute kidney injury (AKI) in primary care - This module will help a GPwER in renal health to recognise patients at increased risk, detect AKI and initiate appropriate management. It will also help them to respond to the automated alerts appearing on renal function results. This course was developed in partnership with Think Kidneys. This course is free to RCGP members. Non-members can purchase it on the RCGP website.

Chronic Kidney Disease

A GPwER in Renal Health should aim to gain a better understanding of use of KFRE (The Kidney Failure Risk Equation) is a well-validated risk prediction tool for a kidney replacement therapy (KRT).

Cardio-Vascular Renal Metabolic (CVRM)

A GPwER in renal health should gain additional knowledge regarding the escalation of treatments, for example; ACE inhibitors, Sodium-dependent glucose cotransporters (SGLT) and finerenone.  They should also be able to use data and dashboards to identify patients that are undiagnosed or not on targeted treatments.

  • Cardio-Renal-Metabolism Hub - This suite of courses looks at the cardiological, renal and metabolic systems and how they are interrelated in the cardio-renal metabolic syndrome (CRM).
  • The Management of Diabetic Kidney Disease - This screencast looks at chronic kidney disease in the setting of diabetes, focusing on the scale of the problem and the steps that can be taken to reduce the risks of it developing or to slow progression.
  • Cardiorenal metabolic disease - This eLearning course describes a series of interwoven conditions including type 2 diabetes, hypertension, hyperlipidaemia, chronic kidney disease and heart failure.
  • Primary Care Diabetes Society - The journal publishes original research articles and high-quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting.

Research

A GPwER in renal health should gain an understanding of some of the clinical trials taking place to improve the outcomes for patients with CKD.   

Gaining practical skills in the extended role

  • Undertake mentoring via regional renal units and local nephrology consultants/GP with kidney disease champions.
  • Utilise all available guidelines to apply knowledge and skills.
  • Utilise the MDT to support patient care but also enhance own learning and knowledge.
  • Work within the practice, PCN and ICB structures to develop the system of care, for example utilising ARRS.
  • Implement work within integrated neighbourhood teams.

All of the above require reflection, sharing of knowledge beyond the practice/PCN, regular quality improvement activity and audits on showing and sharing the case for change.

Patient communication

The GPwER should be the starting point in a journey of communication with people living with kidney disease, those at risk of kidney disease and their social networks. The GPwER should signpost patients to appropriate resources, including those from charities such as Kidney Care UK and Kidney Research UK, to support their education and to empower them to make lifestyle changes. The GPwER should co-ordinate the appropriate professionals to communicate with the individual, for example making use of pharmacists for medication optimisation, dietitians, health coaches for smoking and lifestyle advice, and social prescribing where there may be isolation, mental health or financial challenges. The GPwER should consider the use of novel interventions such as group education, as a means of supporting holistic patient care.

The GPwER has an essential role in guiding patients through 'steps' depending on local resources and waits for secondary care may impact for example journey of education for patients.

Demonstration of continued competence

Competence as a GPwER in Research Delivery is maintained through regular engagement with training and professional development. GCP certification should be refreshed every two or three years (depending on study and sponsor regulations), and study-specific training must be completed at the commencement of each study and whenever protocol amendments occur.

The RCGP Research Ready programme provides a structured approach to supporting and standardising research-active GP practices. The NIHR Learn platform offers a wealth of high-quality training resources, enabling GPs to develop and maintain the skills necessary for delivering safe, effective, and compliant research.

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