Educating at-risk communities in Wales to protect against kidney disease
A woman from Cardiff has made it her mission to increase early diagnosis in people at risk of kidney disease, after her father's battle with diabetes ultimately led to kidney failure.
Rajani Ponnada leads the ‘Diabetes - Prevention Against Chronic Kidney Disease Through Early Diagnosis’ (D-PACTED) project in Cardiff and Newport, which seeks to inform and empower people living with diabetes in at-risk communities to have their kidney health tested.
Funded by NHS Wales Executive, the project is being delivered by Kidney Research UK, Diabetes UK Cymru, Kidney Wales and community organisations. Having previously volunteered for the project (and being diagnosed with diabetes herself), Rajani has since been appointed to drive it in the position of peer educator co-ordinator.
Diabetes is the largest cause of kidney disease, with almost one in five people living with diabetes needing kidney treatment in their lifetime. However, early detection of kidney problems can enable steps to be taken to prevent or slow the progression of kidney disease, improving quality of life and reducing the likelihood of kidney failure.
That’s why Rajani, on behalf of the D-PACTED project, is urging people living with diabetes to have a urine albumin-creatinine ratio (uACR) test to evaluate their kidney health. The project is targeted at those from lower socio-economic and South Asian communities, who are particularly at risk, but most typically underserved by health services.
Rajani says: “We want to raise awareness of kidney health and support people to advocate for themselves in healthcare settings, ensuring they are knowledgeable about what tests and treatments are available. I regularly attend events in the community, providing information and speaking in mosques, temples and churches to reach people who will benefit.”
Early prevention
The D-PACTED project was launched in 2023, in response to the low rate of uACR testing in Cardiff and Newport.
Rajani says: “Many people, like me, have a family history of diabetes, high blood pressure or kidney disease. It’s common for people to feel a sense of inevitability about inheriting a genetic condition and feeling that there is little that can be done to change their story.
“The reality is that there is often something that can be done to protect our health and that can start by simply having the knowledge to ask your GP for a uACR test. Having the confidence to take that step is powerful and an early diagnosis can improve somebody’s quality of life immeasurably.”
The uACR test measures the amount of protein called albumin in the urine and can detect early signs of kidney problems. This provides an opportunity to stop patients from developing kidney failure.
Rajani says: “I didn’t know much about my diabetes when I was diagnosed. It had always been in my family, and I needed insulin for 15 years until I learnt more about how to protect my health. Having the knowledge to make lifestyle changes to my diet and exercise, and having my kidney health tested, made a big difference in my life.
“I’m very passionate about making a change for the wider community. It’s sad to see diabetes and kidney disease still affecting people’s lives despite advancements in healthcare. Nobody wants to be unwell and it’s upsetting when somebody could have been protected if they’d had more awareness at an earlier stage.”
At-risk communities
Reaching people from lower socio-economic and South Asian communities who are at higher risk of diabetes and kidney disease, is important to Rajani.
Rajani says: “We live in such a modern world but there are still barriers to people receiving the right support. I am intolerant of social injustice and want to ensure people have access to services whatever their background.
“Awareness of health and wellbeing is still lacking, and I am passionate about working with marginalised communities to increase knowledge of early diagnosis and the tests which are available. Having that information and being empowered to act can transform people’s lives.
“During Diwali I delivered a talk and I know it led somebody to go to their GP for a uACR test. That’s the first step, to give people the confidence to go. If it then prevents somebody going into kidney failure, that’s a huge success.”
Making an impact
Rajani has been part of an amazing team of D-PACTED volunteers who were named as runners-up at the Cardiff Volunteer Awards in September 2024.
Rajani says: “Being recognised for the hard work everybody is doing was affirming – our message is not falling on deaf ears! The project has been very positively received, and people have been really engaged.
“I get invited to lots of events where I can speak about diabetes and kidney disease. It’s nice that people recognise the work we’re doing and actively want me to come and speak to their communities.
“I hope more funding will go into early diagnosis and early intervention. A simple test can save and change lives, ultimately helping the NHS too, by preventing conditions becoming more serious. If more investment is not made in education and prevention, even more money will be needed to treat those conditions down the line.”
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