Kidney disease costs the NHS in England more than breast, lung, colon and skin cancer combined, yet too many cases remain undiagnosed and untreated, and better drug prescribing for the condition could save the NHS around £13 million a year, says a new report.

Chronic kidney disease (CKD) costs the NHS in England over £1.4 billion a year - more than the £1.37 billion which the Service spends annually on breast, lung, colon and skins cancer, according to the study, which is produced by NHS Kidney Care and has been published in the journal Nephrology Dialysis Transplantation.

Treatment of kidney disease, including complications such as heart disease and stroke, swallows up £1 in every £77 spent by the NHS in England, and nearly half of this goes on renal replacement therapy. However, many people are not receiving help to tackle the disease in its earlier stages when it could prevent the need for expensive dialysis treatment, says the study.

Around 1.8 million people in England have been diagnosed with CKD, and there are though to be around a million more with the condition who have yet to be diagnosed.

The number of people receiving dialysis or transplant increased 29% during 2002-08, and the total prevalence of CKD, both diagnosed and undiagnosed, is believed to be increasing, the study reports. It is also estimated that nearly 30,000 people with CKD are not receiving essential medication to slow its progression, and this is leading to poorer health outcomes and a massive drain on NHS resources.

During 2009-11, 500,000 people with CKD were not tested to see if they would benefit from angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARB) drugs, the study finds. Had they been, it estimates that a further 29,000 people might have been prescribed these drugs, which would improve their health outcomes and save the NHS around £13 million a year.

Earlier diagnosis and treatment significantly improves people's quality of life, cuts their risk of heart attacks and stroke and minimises their likelihood of needing dialysis or transplant. The study finds that there are around 7,000 extra strokes and 12,000 extra heart attacks each year among people with CKD, costing the NHS as much as £178 million a year. Social care for people who have had strokes adds an extra £130 million to the total bill, it adds.

NHS Kidney Care is urging GPs and other primary care clinicians to improve the detection and early treatment of CKD, and has developed a range of professional resources to help them do this.