Chronic Kidney Disease (CKD) is a significant and growing public health problem, responsible for substantial burden of illness and premature mortality. In Australia, it is a fact that 1 in 3 adults is at increased risk of developing CKD.  For a range of statistics refer below and find more detailed references in the current version of our Kidney and Urinary Fast Facts.

Adult Australians are at risk of CKD if they: 

•  Have high blood pressure (hypertension)
•  Have diabetes
•  Smoke cigarettes
•  Are obese
•  Have a family history of chronic kidney disease
•  Are over 50 years of age
•  Are of Aboriginal and Torres Strait Islander descent

Who is at more risk of Chronic Kidney Disease?

• High blood pressure affects 1 in 4 Australians (50% do not have blood pressure managed to target levels)
• Diabetes affects 7.6% of Australians aged over 25 years (50% of whom are undiagnosed)
• 19.5% of Australians aged over 14 years smoke daily
• 2.6 million adult Australians aged over 25 years are obese
• 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
• Prevalence of CKD in some Aboriginal and Torres Strait Island communities is also higher due to increased levels of:
  
  • poor nutrition
  • high alcohol use
  • streptococcal throat and skin infection
  • socioeconomic disadvantage resulting in low levels education, high unemployment, low income, crowded living conditions and low birth weight babies

What causes Kidney Disease?

The three top causes of CKD in Australia are:

• Diabetes, 34% of new cases
• Nephritis or inflammation of the kidney, 22% of new patients
• High blood pressure (hypertension), 14% of new cases

How many people have Chronic Kidney Disease?

• 1 in 7 Australians 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)
• Proteinuria is found in 2.4% of the total Australian population.  It is four times higher in people with diabetes and five times higher in those with high blood pressure
• The incidence of kidney failure is increasing in the Aboriginal population at a faster rate than in non-Aboriginal Australians
• The overall death rates from CKD are up to ten times higher in the Aboriginal and Torres Strait Islander communities compared to the rest of the Australian population

There is consistent evidence that with proper medications and management, the number of people with kidney failure can be significantly reduced. However, early stages of kidney disease often go unrecognised, and the knowledge of what can be done to help patients is often not applied.

How many Australian have treatment for Kidney failure?

The most recent data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry show:

• 2,476 people started kidney replacement therapy (dialysis or transplant) in 2007
• The number of people on dialysis increased by 5% from 2007 to 2008, and has averaged a 6% growth rate per year over the past decade
• Although Indigenous Australians represent less than 2.5% of the national population, they account for approximately 10% of people commencing kidney replacement therapy
• 228 of people diagnosed with CKD are referred ‘late’ to a nephrologist i.e. less than 3 months before first treatment for kidney failure
• In Australia late referral is more common among people of Pacific Island (33%), Indigenous Australian (32%), Maori (30%), or Asian (25%) heritage compared with the Caucasoid population (23%)

Dialysis

• A total of 10,062 people were receiving dialysis treatment at the end of 2008
• 23% were receiving dialysis at a hospital, 31% were dialysing at home and 45% in satellite centres
• Home dialysis includes:
  • continuous ambulatory peritoneal dialysis (9% of all dialysis)
  • automated peritoneal dialysis (12% of all dialysis)
  • home haemodialysis (9% of all dialysis)
• Rates of home haemodialysis range from 14% in NSW to 1% in SA
• Home haemodialysis patient numbers in each State/Territory at the end of December 2008:
  NSW 467:  Qld 191:  ACT 23:  Vic 204:  TAS 8:  SA 8:  WA 27:  NT 20

Transplantation

• In 2008, only 6.5% of the people on dialysis received a transplant, a increase from 5.2% in 2007 and 5.78% in 2006
• The average waiting time for a transplant is about 4 years but waits of up to 7 years are not uncommon.
• On average one Australian dies each week while waiting for a transplant
• The survival rate following a kidney transplant is high - 98% of recipients are alive at 1 year, and 88% are alive at 5 years
• In 2009, Australia had a deceased organ donation rate of 11 donors per million population (pmp).
• There were 247 organ donors in Australia in 2009 compared with 257 in 2008 and 198 in 2007.
• Live kidney donations represented 44% of all kidney transplants in 2008, which was the same in 2007. 
• As at 31 December 2008, 13% (1,258) of the 10,062 people receiving dialysis were on the transplant waiting list

• The majority of people on the waiting list are aged less than 55 years and 83% are waiting for their first transplant

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 haemodialysis - $82,764
  • satellite haemodialysis - $48,631
  • home haemodialysis - $44,739
  • peritoneal dialysis (CAPD) - $56,828
• The cost of dialysis in 2006 is estimated to be $646.6 million
• On 2005 figures the cumulative cost of dialysis from 2004 to 2010 is expected to be $4.5 billion
• The cost of a transplant for a kidney recipient in the first year is $65,375 – $70,553
• The cost for a transplant recipient in subsequent years is $10,749 per annum
• The cost of a live kidney donation in relation to the donor is $8,178
• The cost of a deceased kidney donation in relation to the donor is $3,000
• These costs demonstrate that for every kidney donation, there is a substantial saving to government in relation to the health expenditure. The direct costs savings after the first year post transplant, would be around $60,000 to $70,000 per annum for each patient receiving a kidney donation

How many Australians get Kidney Stones

• 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 if you have a family history of stones and as you age
• Urinary tract stones are more common in children in developing countries and amongst Indigenous Australians
• 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
• People with type 2 diabetes (non-insulin dependent) are at more risk of developing kidney stones in general, particularly uric-acid stones

Urinary Health

• 1 in 20 Australians regularly suffer from urinary incontinence
• During childhood 8% girls and 1% boys have a urinary tract infection (UTI)
• Acute, uncomplicated UTIs are a common problem in women
• There is a high incidence of UTIs in females aged 20 to 40 years who are young and sexually active as well as those who are post-menopausal
• Women with a UTI tendency may have initially experienced UTIs as girls
• 27% to 48% of healthy women with one UTI will experience recurrent infection
• There is some evidence that use of cranberry juice may decrease the number of symptomatic UTIs over a 12 month period for women

How many Australians die of Kidney Failure

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

• Kidney failure is rising as a significant cause of death.
• In 2008, diseases of the kidney and urinary tract were the 10th leading cause of death in Australia with 3224 deaths.
• The number of deaths due to diseases of the kidney and urinary tract exceeds deaths from prostate cancer (3031), breast cancer (2788), and road accidents (1509).

ANZDATA Registry - Kidney Health Australia proudly supports the Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, 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. Read the latest reports, available from ANZDATA Registry. 

Supporting References

Other useful Australian CKD references