Support topic

Chronic Kidney Disease

A plain-English guide to chronic kidney disease (CKD): what an eGFR or urine ACR result means, how CKD is staged and monitored, keeping medicines safe, what to do when you are ill, and how dialysis, transplant and everyday support work in the UK.

Start here

Who this page is for

This page is for anyone who has just been told that a blood or urine test may show a kidney problem, anyone trying to make sense of an eGFR, creatinine or urine ACR result, and anyone already living with chronic kidney disease. It is also written for people with diabetes, high blood pressure, heart or circulation problems or a previous acute kidney injury, for people approaching dialysis or transplant assessment, and for relatives and carers.^{[1]NHS — chronic kidney disease}

Chronic kidney disease is usually shortened to CKD.
It means the kidneys have a continuing problem with their structure or how well they work.
A kidney problem generally needs to have been present for at least three months before it is described as chronic.
One abnormal blood test does not necessarily confirm CKD. Results are usually repeated and interpreted together.
Early CKD often causes no symptoms and is commonly found through routine blood or urine tests.
CKD does not automatically mean kidney failure or dialysis. Most people with CKD never need either.
Treatment and regular monitoring can help protect kidney function and reduce the risk of heart and circulation problems.^{[11]NICE NG203}
Sixpence Support UK provides information and starting points. We do not diagnose anyone and we do not replace professional care.

Get urgent medical help

Call 999 now if you or someone else has:

severe difficulty breathing
chest pain or chest pressure
collapse, unresponsiveness or a seizure (a fit)
sudden severe confusion
symptoms of a stroke — a face that has dropped on one side, weakness in an arm, or slurred or muddled speech
uncontrolled or heavy bleeding from a dialysis fistula, graft or other access site
any other sudden, life-threatening deterioration

If a dialysis access site is bleeding heavily:

call 999 straight away
apply firm, direct pressure over the bleeding point with clean material
keep the pressure on while you wait for the ambulance
follow the instructions given by the 999 call handler

Use NHS 111, or contact your GP or kidney team for urgent same-day advice, if you have:

passed much less urine than usual, or suddenly stopped passing urine
persistent vomiting or diarrhoea
been unable to keep fluids down
worsening dehydration, dizziness, drowsiness or confusion
swelling that is increasing quickly
new or worsening breathlessness
blood you can see in your urine
fever, shivering, redness, pain or discharge around a dialysis access, catheter or transplanted kidney
felt seriously unwell during or after a dialysis session
known CKD with a sudden, significant deterioration in how you feel

These symptoms can have causes other than kidney disease, but they should never be ignored. Equally, not every CKD symptom is a 999 emergency — tiredness, mild swelling or itching usually need a routine appointment rather than an ambulance.^{[5]NHS — acute kidney injury}

Key points

Early CKD often has no symptoms at all.
Diagnosis normally uses both a blood test and a urine test.
eGFR estimates how well the kidneys are filtering. Urine ACR checks whether a protein called albumin is leaking into the urine.
Results usually need confirming and interpreting over time, not judging from one reading.
CKD is classified using both a G stage and an ACR category.
Blood pressure, diabetes control, not smoking and heart health all matter.
Never change prescribed medicine without professional advice.
Anti-inflammatory painkillers such as ibuprofen may not be suitable for some people with CKD — ask a pharmacist or GP first.
Sudden illness and dehydration can cause acute kidney injury.
Most people with CKD do not go on to develop kidney failure.

BackgroundWhat the kidneys do

Most people have two kidneys, roughly the size of a fist, sitting towards the back of the abdomen. They:

remove waste products and extra water from the blood, which leave the body as urine
help regulate salts and minerals such as sodium, potassium, calcium and phosphate
help control blood pressure
support the production of red blood cells
help keep bones healthy, partly by activating vitamin D
balance the acidity of the body

When kidney function declines, these jobs are done less efficiently. That can gradually lead to fluid building up, salts drifting out of their usual range, blood pressure becoming harder to control, or anaemia developing. Most of these changes happen slowly, are picked up on blood tests, and can be monitored and treated.^[1]NHS

Understanding itWhat chronic kidney disease means

CKD is different from acute kidney injury (AKI), which is a sudden drop in kidney function.
“Chronic” means continuing or long-term. It does not mean severe.
A reduced eGFR can happen temporarily during an acute illness or when someone is dehydrated.
Kidney damage can exist even when the eGFR looks normal — for example when the urine ACR is raised.
Repeat testing is often needed before CKD is confirmed.
CKD can remain stable for many years.
Risk depends on the eGFR, the urine ACR, the underlying cause, other health conditions, and how the results change over time.^{[11]NICE NG203}

CKD compared with AKI: CKD is a persistent problem lasting at least three months. AKI is a sudden decline in kidney function developing over hours or days, often triggered by dehydration, infection or certain medicines. AKI can happen to someone with existing CKD or to someone whose kidneys were previously healthy, and it often improves with prompt treatment.^{[5]NHS — AKI}

SymptomsSymptoms to be aware of

Early CKD commonly causes no symptoms whatsoever. Where symptoms do appear, usually in more advanced disease, they may include:^{[2]NHS — symptoms}

tiredness or weakness
swollen ankles, feet, legs or hands
shortness of breath
feeling sick or having less appetite
itchy skin
muscle cramps
disturbed sleep
needing to pass urine more often, particularly at night
changes in the urine, such as it looking frothy
difficulty concentrating
headaches
blood in the urine

These symptoms can have many different causes, most of which are not kidney disease.
Symptoms alone cannot diagnose CKD — testing is needed.
Blood you can see in your urine should always be medically assessed. Do not assume it is caused by CKD.^{[6]NHS — blood in urine}
Severe or rapidly worsening symptoms need urgent help, as set out in the panel above.

TestingWho may be offered kidney checks

Kidney testing is usually offered to people who have a particular reason for it, rather than to everybody. NHS and NICE guidance suggests testing should be considered for people with:^{[11]NICE NG203}

diabetes
high blood pressure
cardiovascular disease, such as angina, previous heart attack or stroke
heart failure
a previous acute kidney injury
conditions affecting the urinary tract or bladder outflow
kidney stones or repeated blockage of the urinary tract
a family history of kidney disease, or an inherited kidney condition
autoimmune conditions that can affect the kidneys
regular use of medicines that can affect kidney function
blood or protein found in the urine
older age combined with other relevant health risks

Age on its own does not confirm kidney disease, and kidney results normally change gradually with age. Results must always be interpreted for the individual, alongside their history and other tests.

TestsTests and what the results mean

Tap or click each heading to open it.

Blood pressure and medical history

Your clinician will usually ask about symptoms, urinary problems and swelling.
They will review all your medicines, including anything bought over the counter.
They will ask about diabetes, heart health, previous infections and kidney stones.
They will ask about family history of kidney disease and any previous acute kidney injury.
Blood pressure will be measured, and may be rechecked at home or over 24 hours if the reading is high.^{[10]NHS — high blood pressure}

Creatinine and eGFR

Creatinine is a waste product from muscles, measured in a blood sample.
eGFR stands for estimated glomerular filtration rate. It is calculated from the creatinine result together with other information such as age and sex.
eGFR is an estimate, not an exact percentage of kidney function. Two people with the same number can be in very different situations.
The trend over time is often more useful than any single result.
Temporary illness, dehydration, muscle mass, some medicines and a recent large meal containing meat can all affect the result.
Your clinician may ask you to repeat the test before drawing any conclusions.

Urine ACR

ACR means the albumin-to-creatinine ratio, measured in a urine sample.
It checks whether albumin, a protein, is leaking into the urine.
Albumin in the urine can be an early sign of kidney damage, sometimes before eGFR changes.
A repeat sample, often first thing in the morning, may be requested to confirm the result.
Urinary infection, menstruation, strenuous exercise and acute illness can sometimes affect urine findings, so timing matters.^{[11]NICE NG203}

Urine dipstick and blood in the urine

A dipstick test can look for blood, protein, glucose or signs of infection.
An abnormal dipstick usually needs confirming with a laboratory test.
Blood found in the urine, whether visible or only on testing, may need further investigation to look for causes unrelated to CKD.^[6]NHS

Other blood tests

Potassium and other salts, which can be affected by kidney function and by some medicines.
Bicarbonate, which reflects the acid balance in the blood.
A full blood count, which can show anaemia.
Bone-related tests such as calcium, phosphate, vitamin D and parathyroid hormone.
Diabetes monitoring tests such as HbA1c, where relevant.
Cholesterol and other tests chosen for the individual.

Which tests you have, and how often, depends on your situation. Ask your clinician what each result means for you rather than comparing your numbers with somebody else’s.

Ultrasound and other investigations

An ultrasound scan can show the size and shape of the kidneys, cysts, stones or a blockage in the urinary tract.
Further blood tests may look for autoimmune or inflammatory causes.
Other scans may be arranged if a structural problem is suspected.
Genetic testing may be offered where an inherited condition is suspected.
A kidney biopsy, where a tiny sample of kidney tissue is examined, is used only when it will change treatment decisions.

Most people with CKD do not need every one of these tests.

StagesUnderstanding CKD stages

CKD is described using two things together: a G category based on eGFR, and an A category based on urine ACR. eGFR is reported in units of mL/min/1.73m², which is simply a standard way of comparing results between people of different body sizes. We give the numbers without the unit below.^{[11]NICE NG203}

CKD G categories based on eGFR
G category	eGFR	What it generally means
G1	90 or above	Normal or high filtering. CKD is only present if there is other evidence of kidney damage, such as raised urine ACR.
G2	60 to 89	Mildly reduced filtering. Again, CKD requires other evidence of kidney damage as well.
G3a	45 to 59	Mildly to moderately reduced filtering. Many people in this group stay stable for years.
G3b	30 to 44	Moderately to severely reduced filtering. Usually means closer monitoring.
G4	15 to 29	Severely reduced filtering. Specialist kidney care is usually involved.
G5	below 15	Very severely reduced filtering, sometimes called kidney failure. It does not automatically mean dialysis starts immediately.

Urine albumin-to-creatinine ratio categories
ACR category	Urine ACR	What it generally means
A1	below 3 mg/mmol	Normal to mildly increased albumin in the urine.
A2	3 to 30 mg/mmol	Moderately increased. Often prompts a repeat test and a review of treatment.
A3	above 30 mg/mmol	Severely increased. Usually needs closer review and may prompt specialist advice.

G1 or G2 on its own does not confirm CKD. There must also be another marker of kidney damage, such as a raised urine ACR, blood in the urine, a structural abnormality or a known kidney condition.
Risk is judged using the G category, the ACR category and the change over time together.
A lower eGFR or a higher ACR generally means closer review, but only a clinician can interpret the complete picture.
Stage 3 CKD is not kidney failure, and for many people it remains stable for years.
Please do not try to diagnose yourself from a single laboratory result.
Repeat tests are often needed to tell CKD apart from a temporary change or an acute kidney injury.

CausesPossible causes

diabetes
high blood pressure
inflammation of the kidney filters, sometimes called glomerulonephritis
inherited conditions such as polycystic kidney disease
repeated or severe kidney infections
blockage in the urinary tract, prostate problems or kidney stones
autoimmune disease affecting the kidneys
long-term effects of certain medicines
a previous severe acute kidney injury
sometimes no single cause is ever identified

CKD is not somebody’s fault. Many causes are entirely outside a person’s control, and knowing the cause mainly helps the clinical team choose the right monitoring and treatment.^[1]NHS

TreatmentTreatment and monitoring

There is usually no single treatment for CKD itself. Care focuses on treating the cause, protecting kidney function, reducing heart and circulation risk, and managing any complications.^{[4]NHS — treatment}

Regular monitoring

Monitoring usually includes eGFR, urine ACR, blood pressure and other blood tests.
How often you are checked depends on your G stage, your ACR category, the underlying cause, your treatment and how quickly your results are changing.
Some people are reviewed once a year; others need checks far more often.
Extra tests are often arranged after an illness, a hospital admission or a medicine change.
Keeping your own record of results makes it much easier to see the trend.

Blood-pressure management

Managing blood pressure is one of the most effective ways to protect the kidneys.
It also lowers the risk of heart attack and stroke, which matter greatly in CKD.
Individual blood-pressure targets differ depending on age, urine ACR, diabetes and other conditions, so we do not publish a single target here. Ask what your personal target is.
Home monitoring may be suggested; ask which monitor to use and how to record readings.
Reducing salt, being active where possible and moderating alcohol can all help.

Diabetes management

Good diabetes care helps protect the kidneys as well as the eyes, nerves and heart.
This normally involves blood-glucose monitoring, medicines and regular reviews.
People with diabetes are usually offered annual kidney checks, including urine ACR.
Cardiovascular protection is an important part of diabetes care where CKD is also present.^{[14]NICE NG28}

Our full Diabetes page is linked in the related pages further down this page.

Medicines that protect the kidneys and heart

ACE inhibitors or ARBs are blood-pressure medicines that can also reduce the amount of albumin leaking into the urine. They are often considered where the urine ACR is raised.
SGLT2 inhibitors are a group of medicines that can help protect kidney function and reduce cardiovascular risk in some people with CKD, with or without diabetes.
Not every medicine suits every person. Suitability depends on your test results, other conditions and the rest of your medicines. We do not publish doses.
Blood tests to check kidney function and potassium are often needed shortly after starting or changing some of these medicines.
Tell your clinician about any side effects rather than stopping treatment yourself.^{[11]NICE NG203}

Cholesterol and cardiovascular protection

CKD increases the risk of heart and circulation problems, sometimes more than it threatens the kidneys.
Cholesterol-lowering treatment is often discussed as part of overall risk reduction.
Stopping smoking, staying active within your ability and managing weight all help.
Decisions are made with you, based on your overall risk rather than one number.^{[13]NICE NG238}

Treating complications

Anaemia — treatment may include iron or other specific medicines.
Mineral and bone problems — calcium, phosphate and vitamin D may be monitored and treated.
Fluid retention and swelling — may be managed with medicine review and, for some people, individual fluid or salt advice.
Itching — there are treatments; it is worth reporting rather than tolerating.
Acidosis — a low bicarbonate level may be treated in some people.
High potassium — may lead to dietary advice, medicine review or specific treatment.
Nutrition — a renal dietitian can help if eating well becomes difficult.

Treatment for each of these depends on test results and, in many cases, specialist assessment.

Kidney specialist referral

Some people are looked after entirely in general practice; others are referred to a kidney (renal) specialist. Referral may be considered where there is:

advanced CKD
a rapid or unexplained fall in kidney function
a high urine ACR
blood and protein together in the urine
blood pressure that remains difficult to control despite treatment
a suspected inherited or rare kidney condition
an uncertain cause, or other findings that concern the clinical team

This is a general summary and not a complete decision tool. The full criteria are set out in NICE NG203 for clinicians, and your GP will weigh up your whole situation.^{[11]NICE NG203}

Medicines and kidney safety

Never stop, reduce, double or restart prescribed medicine without appropriate professional advice.
Tell doctors, dentists, pharmacists and hospital teams that you have CKD.
Check before taking over-the-counter medicines, supplements or herbal products.
Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, and gels or creams containing them, may worsen kidney function or increase the risk of acute kidney injury in some people. This does not mean every person with CKD can never be given one — it needs professional assessment for your situation.
Some medicines need a different dose or extra monitoring when kidney function is reduced.
Do not assume that a “natural” product is safe for the kidneys. Some are not.
Avoid low-sodium salt substitutes containing potassium unless a clinician or dietitian has confirmed they are suitable for you.
If side effects, costs or difficulty getting hold of medicine are causing you to miss doses, say so. There is usually a practical solution.

When you are illIllness, dehydration and personalised sick-day guidance

Vomiting, diarrhoea, fever, poor fluid intake, infection or severe dehydration can put extra strain on the kidneys.
This can cause an acute kidney injury, and the risk is higher in someone who already has CKD.^{[5]NHS — AKI}
Some medicines may need to be paused temporarily during a dehydrating illness. Whether that applies depends on the specific medicine and on the person, so it must be decided individually.
Ask your GP, kidney team or pharmacist whether personalised written sick-day instructions apply to you, and keep them somewhere you can find quickly.
We deliberately do not publish a list telling everyone to stop named medicines, and we cannot tell you to restart anything after a fixed number of hours. That advice has to come from your own clinician or pharmacist.
Do not automatically increase your fluid intake. People with heart failure, advanced CKD or an individual fluid restriction may be advised to keep to a set amount.
If you are unsure what to do, contact NHS 111, your kidney team, your GP or your pharmacist.
Get urgent medical help for markedly reduced urine, being unable to keep fluids down, worsening confusion, severe dizziness, increasing breathlessness or any rapid deterioration.

Prepare before illness:

know who to contact, and keep the number saved
keep an up-to-date list of all your medicines
ask whether personalised sick-day rules apply to you
know whether you have a fluid restriction, and what it is
know when blood tests are needed after an illness
never use somebody else’s sick-day plan — it may be wrong for you

EverydayFood, fluids and everyday life

A generally balanced diet, stopping smoking, appropriate physical activity and moderate alcohol support overall health and help protect the kidneys and heart.
Not everybody with CKD needs a restrictive “kidney diet”. Many people eat normally with only modest changes.
Reducing salt can help blood pressure and swelling.
Advice on protein, potassium, phosphate and fluid must be individualised — it is not the same for everyone.
Unnecessary restriction can lead to poor nutrition, weight loss and weakness.
Ask to be referred to a renal dietitian if specialist restrictions are being suggested.
Detoxes, cleanses and “kidney flush” products are not supported by evidence.
Check before using protein powders, creatine, herbal remedies or high-dose supplements.
People on dialysis often receive different dietary and fluid advice from their unit.

Advanced CKDDialysis, transplant and conservative care

Only a small proportion of people with CKD ever need these treatments. Where they are needed, planning usually begins well in advance so that there is time to choose.^{[7]NHS — dialysis}

Dialysis

Haemodialysis filters the blood through a machine, usually at a unit several times a week, and sometimes at home.
Peritoneal dialysis uses the lining of the abdomen to filter, with fluid exchanges done at home, either during the day or overnight.
Dialysis replaces only part of the work healthy kidneys do, so other treatment continues alongside it.
Planning, including creating dialysis access, often begins before dialysis is actually needed.
The choice of treatment should be made with you, taking account of your health, home situation, work and preferences.
Look after any access site as your unit advises. Report redness, pain, swelling, discharge or fever urgently, and call 999 for heavy bleeding.
Reaching G5 does not automatically mean dialysis starts immediately. The decision depends on symptoms, test results and your own wishes.

Kidney transplant

A transplant involves placing a donated kidney into the body, usually in the lower abdomen.
Assessment looks at general health, heart health, infections and other factors. Suitability is decided individually.
Kidneys may come from a living donor, often a relative or friend, or from someone who has died.^{[17]NHS Organ Donation}
People who are suitable may join the national waiting list while other treatment continues.
Anti-rejection (immunosuppressant) medicine is needed long term, with regular follow-up and blood tests.
Never stop anti-rejection medicine without advice from the transplant team.
A fever, or feeling seriously unwell after a transplant, needs prompt contact with the transplant team or urgent medical care.
A transplant is a treatment rather than a guaranteed cure — transplanted kidneys need looking after and do not always last a lifetime.^{[8]NHS — kidney transplant}

Conservative kidney management

Some people choose active supportive care instead of dialysis, and that is a valid, respected choice.
It still involves medical care: symptom control, medicines, blood tests where useful, and support for the person and their family.
It is chosen for many reasons, including other health conditions, quality of life and personal wishes.
Choosing this path is never the same as being given no treatment.
Decisions can be revisited, and it is always reasonable to ask for a second opinion.

PracticalWork, travel, driving and practical support

Many people with CKD continue working, including some people on dialysis.
Reasonable adjustments may help with fatigue, hospital appointments, dialysis sessions, toilet access, rest breaks or heavy lifting.
Fit notes and occupational-health support can help you and your employer plan sensibly.
For travel, plan ahead: carry an up-to-date medicine list, take enough medicine plus spare, check travel insurance carefully, and arrange dialysis away from home well in advance through your unit.
Dialysis and driving: car and motorcycle drivers generally do not need to tell the DVLA simply because they are on dialysis, but you must ask your doctor when it is safe to drive after a session.^{[15]GOV.UK — dialysis and driving}
Different rules and medical considerations can apply where symptoms affect your driving, or if you hold a bus, coach or lorry licence. Always check the current GOV.UK guidance for your circumstances.^{[16]GOV.UK — health conditions and driving}
Help may be available with benefits, grants, hospital transport, energy costs and complaint letters — see the related pages below.

SupportEmotional wellbeing and support for carers

A diagnosis, fatigue and ongoing treatment can affect mood, sleep, confidence, independence and relationships.
Many people cope well, and distress is not inevitable — but if anxiety or low mood does appear, it deserves help just as much as any physical symptom.
Carers and relatives may need information, practical support and breaks of their own.
Speak to your kidney team, GP or a kidney charity — patient support groups can be very helpful.
If you are struggling to keep yourself safe, get help now through our crisis page or by calling 999 in an emergency.

Mental Health Support Suicidal Thoughts and Crisis Support

Practical checklist

Keep copies of your eGFR and urine ACR results, with their dates.
Ask what your G category and A category mean together.
Attend repeat blood, urine and blood-pressure checks.
Keep an up-to-date list of all your medicines and take it to every appointment.
Check before using painkillers, supplements or herbal remedies.
Ask whether personalised sick-day guidance applies to you.
Find out whether any fluid or dietary restriction applies to you.
Manage diabetes and blood pressure together with your clinical team.
Do not smoke, and ask for stop-smoking support if you need it.
Report visible blood in your urine or any significant change promptly.
Learn the urgent signs of acute kidney injury and serious deterioration.
Ask who to contact between appointments, and seek help with work, benefits, transport or wellbeing.

Official helpOfficial help and information

NHS — chronic kidney disease overview NHS — CKD symptoms NHS — CKD diagnosis NHS — CKD treatment NHS — acute kidney injury NHS — blood in urine NHS — dialysis NHS — kidney transplant NHS Organ Donation NHS 111 online (England)NICE NG203 — CKD assessment and management NICE QS5 — CKD quality standard GOV.UK — kidney dialysis and driving GOV.UK — health conditions and driving (DVLA)Kidney Care UK — patient support (charity, not an NHS service)Kidney Research UK — information and research (charity, not an NHS service)National Kidney Federation — patient helpline (charity, not an NHS service)

Across the UK: NHS 111 online covers England. Elsewhere, start here:

Scotland — NHS inform: chronic kidney disease Wales — NHS 111 Wales health advice Northern Ireland — nidirect illnesses and conditions

In a life-threatening emergency, always call 999.

RelatedOther pages that may help

Diabetes High Blood Pressure Coronary Artery Disease Cholesterol Blood Disorders GP Services Nutrition Care After Hospital Benefits, Grants and Help with Living Costs Gas, Electricity and Water Bills Public Transport and Accessible Travel Free Letter and Complaint Support

Please speak to a healthcare professional

Sixpence Support UK provides general information only. We cannot examine anyone, give a diagnosis, or recommend medicines or doses, and this page is not a substitute for advice from a qualified healthcare professional. Please do not start, stop or change prescribed treatment on the basis of information found online. If symptoms are severe, worsening or worrying you, contact your GP, pharmacist, kidney team or NHS 111 — and call 999 in an emergency.

References

[1] NHS. Chronic kidney disease · 2026
[2] NHS. Chronic kidney disease — symptoms · 2026
[3] NHS. Chronic kidney disease — diagnosis · 2026
[4] NHS. Chronic kidney disease — treatment · 2026
[5] NHS. Acute kidney injury · 2026
[6] NHS. Blood in urine · 2026
[7] NHS. Dialysis · 2026
[8] NHS. Kidney transplant · 2026
[9] NHS 111. Get help with your symptoms (England) · 2026
[10] NHS. High blood pressure (hypertension) · 2026
[11] NICE. Chronic kidney disease: assessment and management (NG203) · 2021, updated 2023
[12] NICE. Chronic kidney disease quality standard (QS5) · 2017
[13] NICE. Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238) · 2023
[14] NICE. Type 2 diabetes in adults: management (NG28) · 2022, updated 2025
[15] GOV.UK / DVLA. Kidney dialysis and driving · 2026
[16] GOV.UK / DVLA. Health conditions and driving · 2026
[17] NHS Organ Donation. Organ donation and the NHS Organ Donor Register · 2026
[18] NHS inform (Scotland). Chronic kidney disease (CKD) · 2026
[19] NHS 111 Wales. Health advice and symptom checkers (Wales) · 2026
[20] nidirect (Northern Ireland). Illnesses and conditions information · 2026
[21] Kidney Care UK. Patient support (charity, not an NHS service) · 2026
[22] Kidney Research UK. Kidney health information (charity, not an NHS service) · 2026
[23] National Kidney Federation. Patient information and helpline (charity, not an NHS service) · 2026