Useful weblinks:  CKD in Australia  (for Health Professionals)

KHA Fact Sheets:  Fast Facts on CKD in Australia 

Kidney Health Australia in collaboration with the National Rural Health Alliance has prepared Fact Sheet No. 35 - March 2013: Kidney Disease in Rural Australia

Who is more at risk of Chronic Kidney Disease?

• 1 in 3 Australians is at an increased risk of develping Chronic Kidney Disease (CKD).
  
• Adult Australians are at an increased risk of CKD if they:
  • are 60 years or older
  • are of Aboriginal or Torres Strait Islander origin
  • have diabetes
  • have a family history of kidney disease
  • have established heart problems (heart failure or past heart attack) and/or have had a stroke
  • have high blood pressure
  • are obese (BMI more than or equal to >30)
  • are a smoker
    
• The greater prevalence of CKD in some Indigenous Australian communities is due to the high incidence of traditional risk factors including diabetes, high blood pressure and smoking, in addition to increased levels of inadequate nutrition, alcohol abuse, streptococcal throat and skin infection, and poor living conditions.

How many people have Chronic Kidney Disease?

• Approximately 1.7 million Australians (1 in 9) over age 25 years have at least one clinical sign of existing CKD, such as reduced kidney function and the presence of proteinuria (protein in the urine) or haematuria (blood in the urine).
  
• The incidence of kidney failure is considerably greater in Indigenous people compared with non-Indigenous people.
  
• Indigenous Australians are almost 4 time as likely to die with CKD as a cause of death than non-Indigenous Australians.

What causes Chronic Kidney Disease?

The three top causes of end stage kidney disease in Australia are:

• Diabetes (35% of new cases)
• Nephritis or inflammation of the kidney (23%)
• Hypertension (15%)

How many Australian have treatment for kidney failure?

Most recent data from Australia & New Zealand Dialysis and Transplant Registry (ANZDATA) shows:

• 2,453 people started kidney replacement therapy (dialysis or transplant) in 2011.
• the number of people on dialysis increased by 4% from 2010 to 2011.
• although Indigenous Australians represent less than 2.5% of the national population, they account for approximately 9% of people commencing kidney replacement therapy each year.
• 22% of people who begin kidney replacement therapy are referred ‘late’ to a nephrologist i.e. less than 3 months before beginning kidney replacement therapy.
• in Australia, late referral is more common among people of Pacific Island (29%), Indigenous Australian (29%), Maori (26%), or Asian (23%) origin, compared with the Caucasoid population (22%).

Dialysis

• A total of 10,998 people were receiving dialysis treatment at the end of 2011.
• 22% were receiving dialysis at a hospital, 27% were dialysing at home and 50% in satellite centres.
• Home Dialysis includes:
  • Continuous Ambulatory Peritoneal Dialysis CAPD (7% of all dialysis)
  • Automated Peritoneal Dialysis APD (12% of all dialysis)
  • Home haemoialysis HD (9% of all dialysis)
• Rates of Home Dialysis range from 38% in New South Wales to 12% the Northern Territory, and 19% in South Australia.

Transplantation

• 825 kidney transplant operations were performed in Australia in 2011.
• As at 3 December 2012 - 1,080 people were waiting for a kidney transplant in Australia.
• This represents approximately 10% of the people receiving dialysis.
• 73% of people on the waiting list are aged less than 60 years, and 79% are waiting for their first transplant.
• The average waiting time for a transplant is about 4 years, but waits of up to 7 years are not uncommon.
• The survival rate following a kidney transplant is high - 98% of recipients are alive at 1 year and 89% are alive at 5 years.
• In 2012, there were 354 deceased organ donors in Australia, who saved or improved the lives of 1,052 people.
• This equates to a rate of 15.6 donors per million population (pmp) - the highest annual total of deceased organ donors and transplant recipients in Australia's history.
• The 354 deceased organ donors in Australia in 2012 compares with 337 organ donors in 2011 and 309 in 2010.
• Live kidney donations represented 35% of all kidney transplants in 2010, down from 42% in 2009.

How much does kidney failure cost the Australian Health System?

• The best available evidence we have on cost per person per year on dialysis is:
  • Hospital or Unit-based Haemodialysis - $79,072
  • Satellite Haemodialysis - $65,315
  • Home Haemodialysis - $49,137
  • Peritoneal Dialysis - $53,112
    
• The costs of treating end-stage kidney disease from 2009 to 2020 is estimated to be around $12 billion to the Australian Government.
  
• Increasing the use of Home Dialysis over the next 10 years is estimated to lead to net savings of between $378 and $430 million for the health system.
  
• Kidney disease contributes to approximately 15% of all hospitalisations in Australia.

How many Australians die from kidney failure?

The most recent data available from the Australian Bureau of Statistics show:

• over 54 people die every day with kidney related disease.
• in 2011, diseases of the kidney and urinary tract were the 10th leading cause of death in Australia, with 3,386 deaths.
• The number of deaths from kidney-related disease has increased 17% since 2002.
• While there has been significant progress over the past 15 years, kidney-related disease kills more people a year than breast cancer, prostate cancer or even road traffic accidents.
  *Causes of Death, Australia 2010, published 2011
• in 2011, disease of the kidney and urinary system contributed to 13.5% of all Australian death.

How many Australians get kidney stones? Useful weblink: Urinary Health KHA webpage

• About 4-8% of Australians suffer from kidney stones at some time.
• The lifetime risk of developing kidney stones is approx 1 in 10 for Australian men, and 1 in 35 for women.
• The chance of developing a stone increases as you age, and also increases if you have a family history of stones.
• After having one kidney stone, the chance of getting a second stone is about 5-10% each year.
• About 30-50% of people with a first kidney stone will get a second one within five years and then the risk declines. However, some people keep getting stones their whole lives.

Urinary Tract Infection (UTI)

• Acute, uncomplicated UTIs are a common problem in women.
• Women are more likely to get a UTI than men.
• Nearly 1 in 3 women will have a UTI needing treatment before the age of 24.
• Around 1 in 2 women and 1 in 20 men will get a UTI in their lifetime.
• Urinary Tract Infections are common, particularly with increasing age.

Useful Australian CKD references