Useful weblinks: CKD in Australia (for Health Professionals)
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Fact Sheet version: 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
Did you know that a person can lose up to 90% of their kidney function before experiencing any symptoms?
Chronic Kidney Disease (CKD) is a significant and growing public health problem, responsible for substantial burden of illness and premature mortality.
WHO IS AT MORE RISK OF CKD?
- 1 in 3 Australians is at an increased risk of developing CKD1.
- Adult Australians are at an increased risk of chronic kidney disease if they:
- are 60 years or older
- have diabetes
- have a family history of kidney disease
- have established heart problems (heart failure or heart attack) and/or have had a stroke
- have high blood pressure
- are obese (Body Mass Index (BMI) - more than or equal to 30)
- are a smoker
- are of Aboriginal or Torres Strait Islander origin
- 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 smoking2, in addition to increased levels of inadequate nutrition, alcohol abuse, streptococcal throat and skin infection, and poor living conditions3.
HOW MANY PEOPLE HAVE CKD?
- Approximately 1.7 million Australians (1 in 10) aged 18 years and over have indicators of CKD such as reduced kidney function and/or the presence of albumin in the urine4.
- Less than 1% of the people with CKD are aware they have this condition5.
- The incidence of kidney failure is considerably greater in Indigenous people compared with non-Indigenous people6.
- After adjusting for age differences, kidney disease is 10 times more common among Indigenous people than among non-Indigenous people7.
- The incidence of end stage kidney disease for Indigenous peoples is especially high in remote and very remote areas of Australia, with rates almost 18 times and 20 times those of comparable non-Indigenous peoples7.
- Indigenous Australians are almost 4 time as likely to die with CKD as a cause of death than non-Indigenous Australians8.
WHAT CAUSES CKD?
The three top causes of end stage kidney disease in Australia in 2012 are6:
- Diabetes (36% of new cases)
- Nephritis or inflammation of the kidney (19%)
- Hypertension (12%)
WHY WORRY ABOUT CKD?
In Australia, CKD is:
KIDNEY DISEASE AMONG INDIGENOUS PEOPLE
- 10% of people attending general practice have CKD, but most do not know it9.
- 42% of people over 75 years of age have an indicator of CKD4.
- People with CKD have a 2 to 3-fold greater risk of cardiac death than people without CKD10.
- For people with CKD, the risk of dying from cardiovascular events is 20 times greater than the risk of requiring dialysis or transplantation11.
- If CKD is detected early and managed appropriately, then the otherwise inevitable deterioration in kidney function can be reduced by as much as 50% and may even be reversible12.
HOW MANY AUSTRALIANS HAVE TREATMENT FOR KIDNEY FAILURE?
- The incidence of kidney failure is considerably greater in Indigenous people compared with non-Indigenous people11.
- After adjusting for age differences, kidney disease is 10 times more common among Indigenous people than among non-Indigenous people12.
- The incidence of end stage kidney disease for Indigenous peoples is especially high in remote and very remote areas of Australia, with rates almost 18 times and 20 times those of comparable non-Indigenous peoples12.
- 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.
- Indigenous Australians are almost 4 times as likely to die with CKD as a cause of death than non-Indigenous Australians13.
Most recent data from Australia & New Zealand Dialysis and Transplant (ANZDATA) Registry6 shows:
- 2,534 people started kidney replacement therapy (dialysis or transplant) in 2012.
- 20,756 people were receiving renal replacement therapy - dialysis or kidney transplantation - at the end of 2012. This represents a 6.6% increase from 2011.
- 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 Islands (29%), Indigenous Australian (29%) or Maori (26%) origin, compared with the Caucasian population (22%).
- A total of 11,446 people were receiving dialysis treatment at the end of 2012. This presents an increase of 4.1% from 2011.
- Of all people on dialysis, 29% dialyse at home.
- Dialysis treatments at the end of 2012:
- 8% use Continuous Ambulatory Peritoneal Dialysis CAPD
- 12% use Automated Peritoneal Dialysis APD
- 9% use Home Haemodialysis HD
- 71% use satellite or hospital dialysis
- In 2012, home dialysis as a percentage of all dialysis increased in Queensland (31%), Australian Capital Territory (22%) and South Australia (22%) from 2011 figures.
- 845 kidney transplant operations were performed in Australia in 2012.
- A total of 9,320 Australians were alive as a result of a functioning kidney transplant at the end of 2012 - this represents a 9.8% increase from 2011.
- As at 3 February 2014 - 1,087 people were waiting for a kidney transplant in Australia14.
- 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 3.5 years, but waits of up to 7 years are not uncommon 15.
- 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 people14.
- In 2013, there were 391 deceased organ donors who saved or improved the lives of 1,122 people16 .
- The 2013 outcome represents a 10% increase from the previous year.
- There were 249 live kidney donations in 2013, a 5% increase on 2012.
Graphic of existing (and projections for 2009 to 2020) for End Stage Kidney Disease in Australia
HOW MUCH DOES KIDNEY FAILURE COST THE AUSTRALIAN HEALTH SYSTEM?
- The best available evidence15 we have on cost per person per year on dialysis is:
- 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 Statistics18 show:
HOW MANY AUSTRALIANS GET KIDNEY STONES? Useful weblinks: Urinary Health and Kidney Stone KHA webpages
- 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) Useful weblinks: Urinary Health
- 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.
Kidney Health Australia proudly supports and collaborates with the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) which provides detailed annual reports and six-monthly interim summaries (from 1997 to present), detailing statistics on the incidence, prevalence and outcome of dialysis and transplant treatment for patient with end stage kidney failure.
OTHER USEFUL AUSTRALIAN CKD REFERENCES
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STATISTICS REFERENCE LIST
(1) Australian Bureau of Statistics. Australian Health Survey: Biomedical Results for Chronic Diseases, 2011-12. 2013. Report No.: 4364.0.55.005
(2) Australian Bureau of Statistics. Australian health survey: First results 2011-12. 2012. Report No.: 4364.0.55.001
(3) Chadban SJ, Briganti EM, Kerr PG et al. Prevalence of kidney damage in Australian adults: The AusDiab kidney study. J Am Soc Nephrol 2003 July;14(7 Suppl 2):S131-S138
(4) Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia's Aboriginal and Torres Strait Islander people: an overview 2011. 2011
(5) Cass A, Cunningham J, Hoy W. The relationship between the incidence of end-stage renal disease and markers of socioeconomic disadvantage. New South Wales Public Health Bulletin 2002 July;13(7):147-51
(6) ANZDATA. Summary of Australia and New Zealand Dialysis and Transplantation, 2012. Australia and New Zealand Dialysis and Transplant Registry, South Australia, Adelaide 2013
(7) Australian Institute of Health. BEACH-SAND Report. Bettering the evaluation and care of health. Chronic renal failure/kidney disease 2007
(8) Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112-S119
(9) Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH. Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Archives of Internal Medicine 2004 March 22;164(6):659-63
(10) Johnson DW. Evidence-based guide to slowing the progression of early renal insufficiency. Intern Med J 2004 January; 34(1-2):50-7
(11) ANZDATA. The 35th ANZDATA Registry Report. Australia and New Zealand Dialysis and Transplant Registry, South Australia, Adelaide; 2013
(12) Stumpers S, Thomson N. Review of kidney disease among Indigenous people. Australian Indigenous Health Bulletin 2013;13(2)
(13) Australian Institute of Health and Welfare. Chronic Kidney Disease in Aboriginal and Torres Strait Islander people 2011. Canberra Australia: AIHW; 2011. Report No.: Cat. No. PHE 151
(14) National Organ Matching System. Australian waiting list. Australian and New Zealand Organ Donation Registry 2013;Available at: URL: http://www.anzdata.org.au/anzod/v1/waitinglist2013.html.
(15) Wright J, Narayan S. Analysis of kidney allocation during 2012. National Organ Matching System www.tsanz.com.au/downloads/2012-NOMSAnalysis.pdf; 2013
(16) ANZOD. Monthly Report on Deceased Organ Donation in Australia, November 2013. Australia & New Zealand Organ Donation Registry, Available at www.anzdata.org.au/anzod/updates/anzod2013summary.pdf; 2013.
(17) Cass A, Chadban S, Gallagher M et al. The economic impact of end-stage kidney disease in Australia: Projections to 2020. Kidney Health Australia, Melbourne, Australia; 2010.
(18) Australian Bureau of Statistics. Causes of death, 2010. 2013
(19) Australian Institute of Health & Welfare. Palliative care services in Australia in 2013. HWI 123, Canberra: AIHW; 2013.
Page updated 3 April 2014