For Kidneys Sake

North West London Kidney Care
  • 5.0 (1)
  • Medicine
  • Updated Semimonthly

For Kidneys' Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)This podcast series aims to provide healthcare professionals, particularly primary care professionals, with accessible insights into kidney health.  Each episode offers bite-sized discussions on key topics such as chronic kidney disease management and heart failure and practical updates for improving patient care. With episodes just 15 minutes long, you can listen on your commute, during a break, or while out for a walk. Join us as we explore the latest advancements and strategies in integrated kidney care to empower clinicians and patients alike.

  1. 4d ago

    A Century of Creatinine and the Endless Search for Accuracy

    Do you have a question? Send it now... This week on For Kidneys Sake, Prof Jeremy Levy and Dr Andrew Frankel celebrate an unlikely centenary: 100 years since creatinine was first recognised as a marker of kidney function. From the early days of serum creatinine and the Cockcroft-Gault formula to today’s eGFR reporting, the duo unpack how kidney function testing evolved and why the numbers we rely on still come with important caveats.  The conversation explores why muscle mass can dramatically distort creatinine-based kidney estimates, when cystatin C offers a better alternative, and why gold-standard nuclear medicine tests remain impractical for routine care.  Along the way, they tackle common misconceptions around eGFR, explain why urine ACR tells a different story entirely, and remind listeners that numbers should never replace clinical judgement. A witty, practical, and surprisingly celebratory deep dive into the science behind every kidney health check.  Top 5 Takeaways 1. Creatinine has been used for 100 years — Serum creatinine was recognised as a marker of kidney function in 1926, making 2026 the centenary year of one of medicine’s most widely used blood tests.  2. eGFR is helpful — but imperfect — eGFR improves on creatinine alone by incorporating age and sex into mathematical formulas, but it still struggles in people with unusually high or low muscle mass.  3. Muscle mass matters more than many realise — A muscular person may appear to have “worse kidneys” on paper, while frail patients with low muscle mass can have deceptively normal creatinine levels despite significant kidney disease.  4. Cystatin C is an underused alternative — Unlike creatinine, cystatin C is not heavily influenced by muscle mass and can provide a more accurate estimate of kidney function in selected patients.  5. Kidney health is more than eGFR — Urine ACR measures kidney damage rather than filtration and can be abnormal even when kidney function appears normal. Both tests matter. 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    20 min

  2. Jun 16

    Wee Need to Talk About UTIs

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) How confident are you that the patient in front of you really has a urinary tract infection? In this episode of For Kidneys Sake, consultant nephrologists Jeremy Levy and Andrew Frankel tackle one of the most common yet surprisingly complex conditions seen in primary care: urinary tract infections (UTIs). They explore why diagnosing a UTI is often less straightforward than it appears, emphasising the importance of symptoms over urine dipsticks and cultures alone. The discussion highlights the risks of overdiagnosis, particularly in older adults and those with asymptomatic bacteriuria, and explains when urine cultures can add value to clinical decision-making.  The conversation also focuses on practical treatment strategies, especially for patients with chronic kidney disease. Jeremy and Andrew discuss antibiotic selection, the limitations of commonly used treatments such as nitrofurantoin and trimethoprim in CKD, and how to approach recurrent or complicated infections. They share evidence-based prevention strategies, review red-flag symptoms that require urgent assessment, and look ahead to emerging options such as vaccines for recurrent UTIs.  5 Key Takeaways Diagnose UTIs primarily through symptoms, using urine tests to support rather than drive decision-making. Avoid treating asymptomatic bacteriuria except in specific circumstances such as pregnancy. Consider kidney function when selecting antibiotics, as some commonly used agents may be ineffective or harmful in CKD. Recurrent UTIs warrant further investigation, including imaging and preventive strategies. Fever, systemic illness, or severe flank pain should raise concern for more serious infection and prompt urgent assessment. 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    23 min

  3. Jun 2

    Prescribing in CKD: What to Stop, What to Use & What to Avoid

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) In this refreshed re-release episode, Professor Jeremy Levy and Dr Andrew Frankel revisit one of the most common and challenging areas in chronic kidney disease (CKD) management: medication reviews and safe prescribing.  They discuss how to approach prescribing decisions as kidney function declines, including the practical use of eGFR over creatinine clearance, how to identify medications that need dose adjustment or review, and the importance of “Sick Day” guidance during intercurrent illness. The episode also tackles common misconceptions around so-called “nephrotoxic” drugs and explains why many beneficial medications can often be continued safely with careful monitoring. The second half of the episode focuses on pain management in CKD — a topic that frequently causes uncertainty in primary care. Jeremy and Andrew outline which analgesics can be used safely, which should generally be avoided, and how to prescribe cautiously using the principle of “start low and go slow.” They cover the safe use of paracetamol, tramadol, oxycodone, fentanyl and neuropathic pain agents, while reinforcing why regular NSAIDs and morphine are usually poor choices in patients with impaired kidney function. A highly practical refresher packed with prescribing tips for clinicians managing CKD in everyday practice. 5 Key Takeaways Use eGFR pragmatically for prescribing decisions in CKD rather than worrying excessively about creatinine clearance calculations.Regular NSAID use should generally be avoided in CKD, although very short courses may be acceptable in selected patients.Metformin is usually safe down to an eGFR of 30, with dose reduction recommended below 45 and good Sick Day guidance essential.Safe analgesic options in CKD include paracetamol, low-dose tramadol, oxycodone and fentanyl — but morphine should usually be avoided.“Start low and go slow” is the key principle when prescribing many medications, especially analgesics, in people with CKD.Resource Links: NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE Northwest 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    20 min

  4. May 19

    Decoding Albuminuria: The One Where We Tell You Not to Panic About Proteinuria

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) In this reflective re-release episode, Dr Andrew Frankel and Prof Jeremy Levy revisit one of the podcast’s most practical and enduring topics: low-level albuminuria and the interpretation of urine ACR testing in primary care. As the podcast prepares for a new series, the team looks back on the importance of recognising albuminuria as an early marker of both kidney and cardiovascular disease, and why confident interpretation of these results remains essential for clinicians managing patients with CKD risk factors.  Andrew and Jeremy reflect on the clinical uncertainty that can arise from mildly abnormal ACR results and offer reassuring, pragmatic guidance on what these numbers really mean. They revisit the A1–A3 categories, discuss when repeat testing is appropriate, explain the difference between ACR and PCR, and emphasise that low-level abnormalities are rarely an emergency. The episode also highlights how albuminuria can be present even when eGFR remains normal, reinforcing the value of early testing and longitudinal monitoring in primary care.  5 Key Takeaways  Albuminuria remains an important early marker of kidney and cardiovascular disease risk.  Mildly raised ACR results should usually be repeated before making long-term clinical decisions.  Nephrotic-range proteinuria is typically far higher than the low-level abnormalities commonly seen in primary care.  Patients can have a normal eGFR while still showing early kidney damage through an abnormal ACR.  A practical, consistent approach to ACR testing helps support earlier identification and better management of CKD risk.Resource Links: NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE Northwest 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    22 min

  5. May 5

    Can I Take This? (Supplements Revisited): Just Because You Can Doesn’t Mean You Should

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) The For Kidneys Sake podcast series, returns with refreshed episodes from our earlier series. With over 30 episodes and 15,000 listeners, we’re revisiting key topics while we prepare our next series.  In this episode, Prof Jeremy Levy and Dr Andrew Frankel explore a common and often overlooked clinical question: what impact do supplements, herbal remedies, and recreational drugs have on people with chronic kidney disease (CKD)? From creatine and high-dose vitamins to anabolic steroids, ketamine, and traditional herbal medicines, this episode challenges the assumption that “natural” means safe. The discussion highlights the importance of asking patients directly about non-prescribed products and explains how some substances can either harm the kidneys or confuse clinical assessment. The core message remains unchanged: creatine is not nephrotoxic but can affect creatinine readings, herbal remedies may be harmful and should be avoided, and high-dose vitamin C and inappropriate vitamin D use can pose risks in CKD. Key Takeaways Ask directly about supplements, herbal remedies, and recreational drugs, they are often missed  Standard multivitamins are generally safe, but high-dose vitamin C and vitamin D can be harmful  Creatine can raise creatinine and lower eGFR without indicating kidney disease  Anabolic steroids and ketamine carry serious kidney and bladder risks  Herbal remedies may be nephrotoxic or interact with medications and should be avoided in CKD  Use a full assessment (ACR, urine dipstick, BP, imaging), not creatinine alone References:  Creatine and kidneys:  Nutrients 2023, 15, 1466.   doi.org/10.3390/nu15061466  Herbal medicines and CKD; Nephrology 15 (2010) 10–17   doi:10.1111/j.1440-1797.2010.01305.x  Herbs and more: Drug stewardship for people with chronic kidney disease; towards effective, safe, and sustainable use of medications:  Nat Rev Nephrol. 2024 June ; 20(6): 386–401. doi:10.1038/s41581-024-00823-3  Resource Links: Resource Links: NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE Northwest 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    27 min

  6. Apr 21

    Sweet Urine Returns: Good Times Still Rolling

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) This episode is a refreshed re-release of “Sweet Urine – Good Times Never Seemed So Good”, one of our early For Kidneys Sake podcasts, revisited to reflect how quickly the evidence base around SGLT2 inhibitors has evolved. Originally developed as glucose-lowering therapies, drugs such as dapagliflozin, empagliflozin and canagliflozin are now firmly established as powerful cardiorenal protective agents. Since the first release, further studies have strengthened the evidence that these medications slow progression of chronic kidney disease (CKD), reduce heart failure events, and improve survival, even in people without diabetes.  Updated NICE guidance now places SGLT2 inhibitors alongside metformin as foundational therapy in type 2 diabetes, marking a major shift in clinical practice. In this episode, we revisit who should receive SGLT2 inhibitors, how to start them safely, and how to manage common concerns in primary care. The discussion reinforces that these drugs should be considered in patients with CKD, heart failure, and diabetes, often irrespective of albuminuria or diabetic status. Practical prescribing advice remains unchanged: select patients carefully (particularly excluding those at risk of ketoacidosis), give clear sick day guidance, and be aware of manageable side effects such as genital fungal infections. Overall, this refreshed episode highlights just how central SGLT2 inhibitors have become in modern kidney and cardiovascular care, and why clinicians should feel confident using them. Top Take aways:  This is a refreshed episode: A re-release of one of our early podcasts, now updated with stronger evidence and evolving guidance on SGLT2 inhibitors.  Think beyond diabetes: SGLT2 inhibitors are now key cardiorenal drugs—protecting kidneys and reducing heart failure and mortality, even in people without diabetes.  Use them early and widely: Indicated in CKD, heart failure (any ejection fraction), and type 2 diabetes—often regardless of albuminuria.  Safe to start with simple rules: Avoid in type 1 diabetes or high DKA risk, give sick day guidance, and adjust insulin/sulfonylureas if needed.  Big benefits, small risks: Side effects are usually mild and manageable, while benefits in slowing CKD progression and reducing cardiovascular events are substantial. Resource Links: NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE Northwest 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    19 min

  7. Apr 7

    Bananas are STILL not the problem! Hyperkalaemia and CKD

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) This episode is a refreshed re-release of our very first For Kidneys Sake podcast, updated to reflect current practice while reinforcing the core messages that remain just as relevant today.  Despite increased awareness, we are still seeing patients with chronic kidney disease (CKD) being referred urgently for potassium levels that are only mildly elevated. This episode revisits how to interpret potassium results correctly, including recognising spurious hyperkalaemia, understanding when repeat testing is appropriate, and being clear that levels in the 5.5–6.0 mmol/L range are usually not an emergency. Urgent action is typically reserved for levels above 6.5 mmol/L or when there are clinical concerns. The refresh also highlights what has strengthened since the original release: even greater evidence supporting the continuation of RAAS inhibitors (ACE inhibitors, ARBs, and MRAs) in CKD and heart failure, alongside the growing role of newer potassium binders such as Lokelma and Veltassa to help patients stay on these vital therapies. We also revisit the persistent myth around dietary potassium—bananas are not the problem—and emphasise that restrictive diets are rarely the solution.  This updated episode offers reassurance, clarity, and practical guidance, while staying true to the original aim: reducing unnecessary panic and supporting confident, evidence-based management of hyperkalaemia in primary care. This is a refreshed classic: A re-release of Episode 1, reinforcing key messages with updated evidence and current practice.  Don’t panic with mild elevations: Potassium levels of 5.5–6.0 mmol/L are usually not an emergency, repeat and review before acting.  Check for spurious results: Delayed sample processing is a common cause of falsely high potassium in primary care.  Keep life-saving medications going: ACE inhibitors, ARBs and MRAs should not be stopped unnecessarily, use potassium binders if needed.  Bananas aren’t the problem: Dietary restriction alone is rarely effective, focus on overall management rather than blaming specific foods. Resource Links: NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE Northwest 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    22 min

  8. Mar 24

    Your Kidneys Called… They Have Questions

    Do you have a question? Send it now... The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS) What are patients really asking when they’re told they have chronic kidney disease?  In this insightful and open episode, Sister Joana Teles steps out from behind the scenes to bring frontline wisdom from the “Know Your Kidneys” education programme. From the deceptively simple (“Is protein in my urine serious?”) to the quietly worrying (“Can my kidneys improve?”), Joana unpacks the real concerns patients carry and challenges clinicians to rethink how we communicate CKD with clarity, confidence, and compassion. Prof Jeremy Levy and Dr Andrew Frankel join the conversation to tackle myths, refine messaging, and emphasise the power of early intervention. Along the way, they cover everything from medication fears and heredity to diet, exercise, and when (not) to refer.  The result? A practical, witty, and highly usable guide for primary care clinicians navigating early CKD conversations. Top 5 Takeaways 1. Protein in urine = CKD (even with normal GFR) > Patients often hear “your kidneys are fine,” but proteinuria alone signals kidney damage and should be labelled and acted on. 2. CKD can “improve” > While eGFR rarely rises, reducing albuminuria meaningfully lowers risks of kidney failure and cardiovascular disease. That’s a win worth explaining. 3. Language matters > Avoiding the term “chronic kidney disease” can create confusion. Clear, honest terminology (with reassurance) empowers patients. 4. Most CKD isn’t hereditary > Aside from conditions like polycystic kidney disease, CKD is usually linked to diabetes, hypertension, and cardiovascular risk. 5. Primary care leads early CKD > Most patients don’t need a nephrologist. With the right tools, knowledge, and confidence, primary care teams are the experts. 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 practitioner’s judgement. You can also join the community by signing up to our newsletter here Produced by award-winning media and marketing specialist Heather Pownall of Heather's Media Hub

    25 min
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For Kidneys' Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)This podcast series aims to provide healthcare professionals, particularly primary care professionals, with accessible insights into kidney health.  Each episode offers bite-sized discussions on key topics such as chronic kidney disease management and heart failure and practical updates for improving patient care. With episodes just 15 minutes long, you can listen on your commute, during a break, or while out for a walk. Join us as we explore the latest advancements and strategies in integrated kidney care to empower clinicians and patients alike.

Information

  • Creator
    North West London Kidney Care
  • Years Active
    2024 - 2026
  • Episodes
    39
  • Rating
    Explicit
  • Copyright
    © 2026 For Kidneys Sake
  • Show Website
    For Kidneys Sake

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