Some 45,000 premature deaths each year, more than lung and breast cancer combined are due to failings in the detection and care of chronic kidney diseases (CKD), according to a new report.
An improved approach could help many people to lead better lives and save the NHS money, say the study commissioned by NHS Kidney Care.
The report says 1.8m people in England have been diagnosed, but suggests there are one million undetected cases. In CKD the kidneys become less effective at filtering waste products from blood.
The study published today in Nephrology Dialysis Transplantation draws its findings from NHS data and economic modelling based on clinical studies.
The paper, Chronic Kidney Disease in England: The Human and Financial Cost, concludes that CKD costs the NHS in England more than £1.4bn a year.
The author, Marion Kerr, said better diagnosis and early treatment - particularly from GPs - could make a big difference.
"Chronic kidney disease has a much greater impact on people's lives, and on NHS costs, than is generally recognised," she said. She says nearly half the spending goes on dialysis or transplantation, yet this accounted for only 2% of all patients diagnosed with CKD.
Ms Kerr said failure to detect the disease meant many people did not get the lifestyle advice and treatment they needed. "Most of the spending on CKD is for people with advanced disease. We hope this report will focus attention on the need for early detection and intervention, to reduce the human and financial cost of advanced kidney disease."
Dr Charlie Tonson, chairman of the Royal College of Physicians renal medicine committee, said chronic kidney disease was an important public health problem.
"Patients with early kidney disease are particularly likely to benefit from lifestyle changes and drug treatments aimed at the risk factors for heart disease and strokes, as these will help reduce the risk of progressive kidney disease," he said.