Chronic kidney disease (CKD) affects around one in ten people in the UK and is frequently diagnosed only after opportunities for prevention have been missed. This policy brief explores whether women with polyendocrine metabolic ovarian syndrome (PMOS), formerly known as PCOS, may represent an overlooked population at elevated risk of CKD. PMOS is increasingly recognised as a multisystem metabolic condition with established links to cardiovascular disease, and emerging evidence suggests a potential association with kidney disease through pathways including chronic inflammation, metabolic dysfunction and oxidative stress. Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom management, e.g., chronic pelvic pain or dysmenorrhea, presents established renal risks. Individuals both with and without PMOS commonly utilise NSAIDs for symptom management. However, evidence is insufficient to determine if NSAID exposure is higher among the PMOS population, and elevated usage should not be assumed.

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Although the evidence remains preliminary and does not justify changes to clinical guidelines at this stage, it highlights an important gap in current prevention efforts. Notably, NICE's draft PMOS guideline includes monitoring for diabetes and cardiovascular disease but does not address kidney health, creating a risk that any emerging CKD burden in this population will remain unidentified.

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This brief recommends a proportionate, evidence-generating response rather than immediate changes to clinical practice. A feasibility and co-design study should be undertaken to determine whether kidney health awareness and referral can be integrated into PMOS care in an acceptable and practical way. Community pharmacy is proposed as a promising setting for early testing because of its accessibility, frequent patient contact and existing experience in CKD risk identification. The brief also calls for consideration of kidney health signposting within the developing NICE PMOS guideline, the design of any future pathway with equity at its core, and the establishment of a cross-sector working group involving endocrinology, nephrology, primary care, pharmacy and patient representatives. Together, these measures would allow policymakers to investigate a plausible but unconfirmed risk while supporting the NHS ambition to strengthen prevention, reduce health inequalities and identify disease earlier.