Glomerular disease care delivery in Ireland

Prof Michael Clarkson, Consultant Nephrologist, Cork University Hospital (CUH), delivered an insightful presentation on glomerular disease care delivery in Ireland at the Irish Nephrology Society Winter Meeting 2026.

In his presentation, Prof Clarkson particularly stressed the importance of how care is structured and organised.

He noted that glomerular diseases are a significant cause of end-stage kidney disease (ESKD) and highlighted the 2023 findings from the RaDaR study (National Registry of Rare Kidney Diseases), which he said challenged nephrologists to change the way they treat and approach patients with glomerular disease.

Prof Clarkson said the study found that reducing proteinuria to <1g/d is important in preventing ESKD and welcomed the fact that more novel drugs are in development.

However, he cautioned that “we need to structure and organise ourselves better” to achieve more success for patients.

He emphasised the importance of early referral through general practice and the need for ongoing education efforts and early access to clinics.

“We need to reach out to our colleagues in general practice and put a bigger emphasis on catching young people with suspected glomerular disease earlier.

“Fewer than 30 per cent of our referrals to CUH include uACR [urine albumin to creatinine ratio] and a urinalysis result,” Prof Clarkson said.

He told delegates that “we should have a higher ambition” towards disease remission, where renal disease is prevented and stopped.

“We are not preventing renal disease, and we still have very limited interventions for many of our patients with glomerular disease,” he said.

Prof Clarkson put forward the argument that all patients newly diagnosed with primary glomerular disease should be managed in a glomerular disease clinic.

At such clinics, patients could gain access to clinical trials, benefit from earlier access to drugs, and get onto registries, all of which he maintained would help to improve the understanding, management, and treatment of the glomerular disease.