Early & Integrated CKD Knowledge Hub

Boehringer Ingelheim has provided funding towards this education, training, and mentorship programme. Boehringer Ingelheim has had no editorial input into or influence on the agenda or content of the programme, including any supporting materials, and has not been involved in the selection of speakers, trainers, or mentors.
overview
Education, data, and quality improvement resources supporting earlier detection and integrated management of chronic kidney disease (CKD) across the UK — for primary care teams, specialists, commissioners, and system leaders.
  • E-Learning courses
  • Quick reference guide
  • Quality improvement dashboards
  • Quality improvement map
  • Meeting recordings
  • Links to additional resources

Date of preparation: February 2026

Bringing CKD care together, wherever you are in the pathway

CKD is common, under-diagnosed, and largely managed in primary care. But improving outcomes at scale depends on primary care and specialist teams working from the same evidence, the same data, and joined-up pathways. A lot of good integrated CKD work is already happening across the UK; the challenge is that it's often happening in isolation, with teams solving the same problems without knowing what's already been tried elsewhere.


The UKKA's Integrated CKD Workstream exists to close that gap through role-specific education, national data and QI tools, and a growing network of teams sharing what's working.


This Hub is where that comes together in one place:

UKKA-developed resources

E-learning courses, a quick reference CKD guide, a UK-wide QI project map, and recordings from knowledge-exchange events.

National Data

CVD PREVENT indicators and other dashboards to help teams see where the gaps are.

Information from existing projects

Reporting shared by teams already doing this work, so others can build on it rather than start from scratch.

The wider landscape

Guidelines and tools from NICE, KDIGO, Kidney Care UK, and other organisations doing related work.

Together, these resources support prevention, risk stratification, and medicines optimisation — and collaboration between primary and specialist services to reduce unwarranted variation, tackle health inequalities, and embed kidney health within wider cardiovascular prevention and population health strategy.

What is integrated CKD?

"Integrated CKD" refers to models that deliberately connect primary care — where the vast majority of CKD is identified and managed — with specialist nephrology input, using shared data, agreed pathways, and pooled workforce capacity.

Integrated CKD projects and programmes are commissioned and delivered at a local or regional level rather than through a single UK-wide programme.
The underlying rationale is shared: CKD remains underdiagnosed and evidence-based testing and treatments remain underused. Closing the gap requires early identification, medicines optimisation, risk-based prioritisation, workforce upskilling, and commissioning across multi-professional teams in primary and secondary care.

In practice, this has produced a range of local delivery models rather than one fixed blueprint.

They tend to share a common set of pillars:
  • Case-finding and coding: systems for proactively identifying people with CKD who aren't yet coded as such, rather than relying on opportunistic detection.
  • Risk stratification: embedding tools like the Kidney Failure Risk Equation (KFRE) so patients are triaged by progression risk in line with NICE guidance.
  • Medicines optimisation: driving uptake of statins, RAASi, SGLT2 inhibitors, and nsMRAs where indicated, with blood pressure control to target to slow CKD progression and lower cardiovascular risk.
  • Cross-setting MDT/specialist access: virtual multidisciplinary reviews or advice-and-guidance links that bring specialist input to primary care without a formal referral.
  • Workforce education: upskilling GPs and primary care teams so more CKD competence sits outside nephrology.
  • Health equity and outreach: targeting deprived or underserved populations where CKD burden and under-coding are highest.

E-Learning for primary care

Chronic kidney disease (CKD) affects around 1 in 10 UK adults and is associated with substantially increased risks of cardiovascular disease, kidney failure, and premature mortality. Preventing CKD, detecting it early, and managing it well helps people live longer, healthier lives while reducing long-term system impact.

Most people with or at risk of CKD are managed entirely in primary care. Our suite of courses is tailored to different professional roles, providing the knowledge and practical tools to help each audience best support patients across the CKD pathway.

CKD for Primary Care: Supporting people with CKD (non-prescribing)

~ 1 hour

A practical course for non-prescribing nurses, non-registered healthcare staff, and others who are supporting people with chronic kidney disease in primary care and community settings.

The course focuses on understanding CKD, making sense of kidney tests (eGFR and urine ACR), and explaining why prevention, monitoring, and treatment matter — even when people feel well. It covers how kidney, heart, and metabolic conditions are linked, why CKD progresses differently, and when concerns should be escalated.

You’ll gain confidence in supporting people with or at risk of developing CKD, reinforcing consistent messages, and working within the wider care team.

CKD for Primary Care: Practical Prescribing Foundations

~ 1 hour

A focused, action-oriented course for busy clinicians who want clear guidance on what to do in everyday practice.

This course delivers step-by-step, evidence-based prescribing and medicines optimisation for CKD from prevention through referral, with an emphasis on reducing cardiovascular risk, slowing kidney decline, and managing complications safely.

You’ll leave with practical treatment pathways, prescribing priorities, and clinical next steps you can apply immediately.

CKD for Primary Care: A Special Interest in Kidney Health

~ 4 hours

A comprehensive course for clinicians who want to deepen their understanding of chronic kidney disease and strengthen their clinical reasoning in everyday practice.

This course builds on practical prescribing and medicines optimisation, adding deeper explanations of kidney physiology and how CKD interacts with cardiovascular and metabolic disease. You’ll explore why specific interventions matter, how CKD progresses differently between individuals, and how earlier, more consistent management can change long-term outcomes.

You’ll develop a stronger understanding of CKD and cardio-kidney-metabolic pathways, and how treatment decisions translate into kidney protection, reduced cardiovascular risk, and safer ongoing care.

Quick reference guide

This quick reference guide summarises key points from the CKD learning, supporting rapid recall in day-to-day practice. It also signposts to further resources for more detail and supporting evidence.

Download our CKD quick reference guide

UK-wide integrated CKD project map

There’s a great deal of quality improvement (QI) work already happening across the UK in early and integrated CKD. 

Our interactive project map shows the current CKD QI landscape, with links to more information about each project. If you're planning a QI project, whether that's developing an integrated CKD clinic, implementing KFRE, or strengthening CKD education, it's worth seeing what's already working and already available before you start from scratch.


Contact the UKKA if you'd like us to put you in touch with a particular project lead, so you can learn from their experience.

The above image is a screenshot of the CKD QI Map.
Click here to launch the interactive version.

Are you running an integrated CKD project, early CKD education initiative, or a KFRE implementation project that is not yet listed?

We'd love to hear about it! Please use the button to the right to share your project details and help us build a clearer picture of CKD improvement work happening across the UK.

Data dashboards for England

CVD PREVENT brings together routinely available data from England to support improvement in cardiovascular and kidney health. Its dashboard includes several CKD-relevant indicators spanning detection, monitoring, and treatment, allowing users to explore variation at practice, PCN, ICB, and regional level.


These measures help highlight opportunities to improve CKD identification, strengthen routine monitoring (eGFR and urine ACR), and optimise treatment for people at higher kidney and cardiovascular risk — including blood pressure control, renin–angiotensin system blockade, and lipid lowering therapy.


Together, these indicators can support local quality improvement by helping teams understand their current position, identify gaps in care, and track progress over time while more CKD-specific national insight tools are in development.

Relevant indicators are the following:

  • CVDP002CKD: Patients whose last two eGFRs are less than 60ml/min/1.73m2 (uncoded CKD), who do not have a record of GP recorded CKD (G3a to G5)
  • CVDP003CKD: Patients whose last single eGFR is less than 60ml/min/1.73m2 (at risk of CKD), who do not have a record of GP recorded CKD (G3a to G5)
  • CVDP004CKD: Patients with GP recorded CKD (G3a to G5) with a record of a urine ACR test in the preceding 12 months
  • CVDP006CKD: Patients with GP recorded CKD (G3a to G5), with a record of an eGFR test in the preceding 12 months.
  • CVDP005CKD: Patients with GP recorded CKD (G3a to G5) and hypertension and proteinuria, who are currently treated with renin-angiotensin system antagonists
  • CVDP007CKD: Patients with GP recorded CKD (G3a to G5) with an ACR of less than 70 mg/mmol, whose last blood pressure reading is to the appropriate treatment threshold.
  • CVDP009HYP: Patients with GP recorded hypertension, with a record of a urine ACR test in the preceding 12 months.
  • CVDP010CHOL: Patients with GP recorded chronic kidney disease (G3a to G5), who are currently treated with lipid lowering therapy.
  • CVDP002HF: Patients with GP recorded heart failure, with a record of an eGFR test in the preceding 6 months.


The CKD National Insight Dashboard brings together routinely available data to support quality improvement in early and integrated CKD care in England, from detection and monitoring to treatment with kidney-protective therapies. It allows users to explore variation at national, regional, ICB, and PCN level, helping identify opportunities for improvement and track progress over time. 

Alongside the dashboard, we are developing a UK-wide project map to showcase and connect integrated CKD projects, KFRE laboratory implementation initiatives, and CKD education projects.

Together, these tools are intended to support shared learning, spread good practice, and strengthen collaboration across the CKD community.

Meeting recordings

This section brings together recordings from workshops, webinars, and knowledge-exchange meetings delivered as part of the Integrated CKD workstream. These sessions focus on commissioning, system leadership, and practical implementation of early CKD identification and management in primary care, supporting shared learning across ICBs, PCNs, and kidney teams.

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The Big Kidney Conversation:
Improving early diagnosis of kidney disease in rural and coastal communities

This recorded half-day event brings together commissioners, clinicians, and system partners to explore how earlier detection of CKD can improve outcomes and reduce inequalities.

Through short talks, case studies, and a collaborative workshop, the session focuses on embedding kidney health within broader cardiovascular prevention strategies, with a particular lens on rural and coastal communities.
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Birmingham, Solihull, and Black Country

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West Yorkshire

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Bristol, North Somerset, and Gloucestershire

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Additional resources

Information for patients and carers

Guidelines and guidance

Quality improvement

Tools, education, and frameworks