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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 episode of For Kidneys'Sake, Dr Andrew Frankel and Prof Jeremy Levy are joined by Dr Khuldir Johal, a GP and clinical lead for the Harrow CRM Hub, to discuss the relationship between obesity and Cardio-Renal Metabolic (CRM) disease. Together, they examine how excess adipose tissue, particularly around the abdomen, can create a pro-inflammatory state that contributes to vascular and organ damage, influencing the development of heart, kidney, and metabolic disorders. The episode emphasises the need to move beyond managing diabetes, hypertension, and kidney disease as separate conditions, and instead adopt a joined-up, clinically integrated approach.

Dr Johal outlines how the Harrow CRM Hub identifies at-risk patients early, using indicators such as raised BMI and type 2 diabetes, then supports them through a longer consultation model, tailored advice, and multidisciplinary care. The focus is on empowering patients to understand and manage their own health through regular monitoring and education, rather than relying solely on medication. The episode concludes with a call for clinicians to recognise the interrelated nature of CRM conditions and intervene as early as possible to reduce the long-term burden on patients and the health system.

Key Takeaways

1. CRM disease is interconnected – Heart, kidney, and metabolic conditions share causes like obesity and inflammation and should be managed together, not in silos.
2. Obesity drives disease – Abdominal fat acts as an inflammatory organ, damaging vessels and accelerating heart and kidney problems.
3. Early detection can reverse risk – Identifying people early and supporting lifestyle change can slow or even reverse progression.
4. Holistic, team-based care works – Longer, integrated consultations involving GPs, coaches, and nutritionists empower patients and improve outcomes.
5. Empower patients – Give people access to their data and help them set realistic goals so they can take ownership of their health.

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)

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association | Circulation

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.

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