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
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 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 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 are6:
- Diabetes (35% of new cases)
- Nephritis or inflammation of the kidney (23%)
- Hypertension (15%)
WHY WORRY ABOUT CKD?
In Australia, CKD is:
- 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?
Most recent data from Australia & New Zealand Dialysis and Transplant (ANZDATA) Registry6 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%).
- 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 Haemodialysis 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.
- 825 kidney transplant operations were performed in Australia in 2011.
- As at 1 August 2013 - 1,048 people were waiting for a kidney transplant in Australia13.
- 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 3.5 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 people14.
- 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 31% of all kidney transplants in 2011, down from 35% in 2011, and 42% in 2009.
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 Statistics16 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.
Graphic of existing (and projections for 2009 to 2020) for End Stage Kidney Disease in Australia
OTHER USEFUL AUSTRALIAN CKD REFERENCES
For more info about kidney health contact our Kidney Health Information Service (freecall) 1800 454 363 or email email@example.com
Join our Kidney Community today - to receive our monthly Kidney Community News which brings you news of interest from the kidney world, local support group activities and events, latest research and more. Subscribe to firstname.lastname@example.org providing your name, professional details, city, state, country and interest in CKD.
STATISTICS REFERENCE LIST
(1) 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
(2) Australian Institute of Health and Welfare (AIHW). The health and welfare of Australia's Aboriginal and Torres Strait Islander people: an overview 2011. 2011
(3) 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.
(4) Australian Bureau of Statistics. Australian Health Survey: Biomedical Results for Chronic Diseases, 2011-12. 2013. Report No.: 4364.0.55.005
(5) Australian Bureau of Statistics. Australian health survey: First results 2011-12. 2012. Report No.: 4364.0.55.001
(6) ANZDATA. The 35th ANZDATA Registry Report. Australia and New Zealand Dialysis and Transplant Registry, South Australia, Adelaide; 2013
(7) Stumpers S, Thomson N. Review of kidney disease among Indigenous people. Australian Indigenous HealthBulletin 2013;13(2)
(8) 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
(9) Australian Institute of Health. BEACH-SAND Report. Bettering the evaluation and care of health. Chronic renal failure/kidney disease. 2007
(10) Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 1998;32:S112-S119
(11) 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
(12) Johnson DW. Evidence-based guide to slowing the progression of early renal insufficiency. Intern Med J 2004 January;34(1-2):50-7
(13) National Organ Matching System. Australian Waiting List 2013. http://www anzdata org au/anzod/v1/waitinglist2012 html
(14) ANZOD. Monthly report on deceased organ donation in Australia. http://www.anzdata.org.au/anzod/updates/anzod2012summary.pdf; 2012
(15) 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
(16) Australian Bureau of Statistics. Causes of death, 2010. 2012
Updated 25 November 2013