Thousands of people living with diabetes in Gloucestershire are using pioneering new technology available via the NHS to test for chronic kidney disease at home, without needing to visit their GP practice, thanks to an app which turns an ordinary smartphone camera into a clinical-grade medical device.

The Minuteful Kidney test – created by healthtech company Healthy.io – enables home-based urine testing, which is critical for picking up early signs of chronic kidney disease, a complication of diabetes dubbed ‘the silent killer’, which affects around 1.8 million people in the UK.

Since being rolled out by NHS Gloucestershire Clinical Commissioning Group last year, over 4,100 people with diabetes have used the Minuteful Kidney test, helping to detect almost 500 additional cases of chronic kidney disease that may otherwise have gone undetected.

Three million people in UK suffer from chronic kidney disease — a long-term condition where the kidney function gradually declines — yet around a third of people are undiagnosed. Under-diagnosis is estimated to lead to 40,000 premature deaths a year.

Known as the ‘silent killer’ because it is asymptomatic until it has reached an advanced stage, chronic kidney disease is a significant risk factor for cardiovascular disease. It can also cause kidney failure, and sufferers may eventually need dialysis and a possible transplant – complications which cost the NHS in England around £1.5 billion every year to treat.

As a leading risk factor for chronic kidney disease, the NHS recommends that people living with diabetes take a urine test to monitor the albumin to creatinine ratio (ACR) as part of their annual diabetes review. The test can help detect early signs of chronic kidney disease, so patients can then receive guidance on lifestyle changes and medication to help slow progression or stop it getting worse.

In 2020, only 45% of people living with diabetes in England had their annual urine ACR test. In Gloucestershire, 47% of people living with diabetes had their test and this digital service is designed to increase this further by making it easier for people to take the test who may have missed their annual review appointment as a result of the pandemic.

Since the programme started last year, 42 GP practices across Gloucestershire have rolled out the Minuteful Kidney testing service and 4,127 at-risk patients have tested for chronic kidney disease, who hadn’t had a test in the previous 12 months.

According to modelling based on an independent peer-reviewed health economics study, the tests taken so far will help Gloucestershire CCG detect an estimated 498 additional cases of chronic kidney disease that would otherwise have gone undetected.

Dr Rob Estelrich, Clinical Lead for Diabetes at NHS Gloucestershire CCG said: “Offering patients the opportunity to do their ACR test at home has led to more patients doing so, meaning that we are able to detect more cases of chronic kidney disease at an earlier stage. This is incredibly important for being able to treat patients effectively and shows how technology can make a real difference to patient care”.

“Chronic kidney disease is a silent killer and has a major impact on society yet very few people are aware of its dangers,” said Katherine Ward, Chief Commercial Officer of Healthy.io. “Thanks to the collaboration with the NHS, our test has already helped early detection of thousands of cases of the disease in England, helping the NHS save money and more importantly ensuring some people avoid the horror of dialysis, transplant or cardiac events”.

How the Minuteful Kidney test works

The test uses image recognition and computer vision technology to turn the smartphone camera into a clinical-grade medical device, allowing people complete their annual urine test at home, without needing to visit their GP practice.

After being identified by their GP practice as a patient living with diabetes who hasn’t had a urine test in the last year, patients are contacted through SMS text or a phone call about the service and are sent a Minuteful Kidney test kit through the post.

The test kit includes a standard dipstick, a urine collection pot in which they dip the stick after giving a sample, and a patented colour board.

They download the accompanying app onto their phone, which then guides them through the test, including how to scan the dipstick on the colour board with their mobile phone camera. Using AI (artificial intelligence) and colorimetric analysis, an algorithm reads the dipstick results as accurately as a lab-based device, and then sends a real-time clinical grade result to the user’s GP practice, so their doctor can review and follow up as appropriate.

The technology has been developed by tech-company Healthy.io, which is collaborating with the NHS as part of the Accelerated Access Collaborative and the National Institute of Health Research.