A mixed methods exploration of the relationship between severe mental illness and chronic kidney disease
People with severe mental illness (SMI), including conditions such as schizophrenia, die 15-20 years earlier than people without SMI. They are more likely to experience long-term health problems, including chronic kidney disease (CKD). Kidney disease will be the fifth leading cause of death worldwide by 2040. Kidney disease causes heart disease, strokes, heart attacks and heart disease-related death, issues that are more common for people with SMI. However, there is little recognition of the role kidney disease plays in the health of people with SMI.
What is already known about the subject
People with SMI are more likely to develop CKD, may be prescribed lithium, which can harm the kidneys, and there is evidence that people with SMI may experience inequalities in accessing high-quality kidney care. However, this area is significantly under-researched, and we know very little about how CKD contributes to the mortality gap or the role of risk factors beyond lithium in the development and progression of CKD.
Who we will be working with
We will be working and collaborating with service users and caregivers who have experience of kidney disease and/or SMI, NHS trusts, primary care services, third sector organisations, colleagues at UCL, KCL, LSHTM, and the Centre for Health Economics at York.
What we will do
We are using a mixed-methods approach to explore the relationship between SMI and CKD. This includes a systematic review to determine the risk of CKD among people with SMI; a systematic review of the clinical outcomes for people with SMI and CKD; analysis of data collected from primary care and hospitals across the UK to explore how CKD and relevant risk factors contribute to outcomes for people with SMI; and interviews and focus groups with patients and service users with co-existing CKD and SMI, their informal carers, and healthcare professionals from mental health services, kidney services and primary care.
What the benefit and impact will be
This study will identify how health inequalities are experienced by and affect people with SMI, and will inform future research to address these inequalities and improve outcomes, ultimately reducing the mortality gap.
When the findings will be available
The findings for the first workstream are already available and published in the British Journal of Psychiatry. The remaining findings will be available by July 2028.
Study duration:
03/2024 – 07/2028
The project is led by Dr Claire Carswell, NIHR Advanced Research Fellow, University of York, Department of Health Sciences