Today, one in seven Australians show at least one indicator of kidney damage. There are often no warning signs for kidney disease - you can lose up to 90% of kidney function before experiencing any symptoms or feeling sick – by then it’s too late. Early intervention can reduce CKD progression and cardiovascular risk by 50%, and improves quality of life.
Our KEY kidney health messages focus on the importance of maintaining a balanced lifestyle and having a regular kidney and urinary health check, particularly for the 1 in 3 Australians who are ‘at increased risk’ of kidney disease.
Be aware - you are at high risk if you: 
- have diabetes
- have high blood pressure
- smoke
- are over 50 years
- are obese, or
- are of Aboriginal or Torres Strait Islander descent
If you are 'at risk', ask your doctor for a kidney health check.
Early detection and treatment can help prevent kidney failure and the need for dialysis or transplant treatment.
What do the stages of CKD mean?
The following is the different stages of chronic kidney disease used by doctors to determine the severity of chronic kidney disease:
Early stages
- small amount of kidney damage, although GFR may be normal
- Often there are no symptoms in the early stages of kidney disease, blood tests can be normal.
- There may be scarring and blockages that change blood flow to parts of the kidney so they don't work as well as they should.
- There is an increased risk of heart disease. You doctor can help you reduce your risk of heart disease.
Middle stages
- sometimes discovered because the level of waste product in the blood rises
- Some people begin to feel unwell and notice an increase in urine frequency.
- Blood pressure can rise as the kidneys slow down. High blood pressure further increases the risk of heart disease, heart attack and stroke.
- Early signs of bone disease may be present.
- Anaemia may appear, caused when there are not enough red blood cells in the blood to carry oxygen around the body. Symptoms include weakness, fatigue and a shortness of breath.
Later stages
- High blood pressure almost always occurs.
- You may start to notice changes in the amount of urine you pass.
- Lack of energy, increased tiredness and reduced appetite are common symptoms.
- You may need to make dietary changes, including limiting the use of salt or reducing the amount of potassium or phosphorus in your diet.
End-Stage Kidney Disease (ESKD)
- The kidneys are only functioning at 10-15 per cent of their capacity and are unable to properly filter waste products, remove extra water from the body and help maintain the blood's chemical balance.
- This is the time to consider commencing dialysis or having a kidney transplant.
Kidney failure brings with it many changes. Adjusting to kidney failure is more difficult for some people than others, even with time to prepare for it. When there is no time to prepare, the sudden impact makes dealing with kidney failure much harder.
If recently diagnosed with kidney problems, we highly recommend our booklet Living with Kidney Failure and Living with Reduced Kidney Function.
Kidney Evaluation for You (KEY) Program
 KEY is Kidney Health Australia’s chronic kidney disease (CKD) early detection and prevention program for the community which aims to find early asymptomatic CKD in high risk individuals and refer them to a primary health care provider for appropriate long-term care. KEY was the first primary heath care program for early detection of CKD to be established in Australia and the first in the world to use point-of-care machines to screen for kidney function. The use of point-of-care technology enabled participants to receive all their pathology results before the end of their visit. This unique aspect sets KEY apart from other screening programs.
Publications and abstract on our Australian KEY Program
Screening for chronic kidney disease in Australia: a pilot study in the community and workplace
Presents the major findings from the KEY pilot study
Kidney International (2010) 77 (Suppl 116), S9–S16; doi:10.1038/ki.2009.538
Timothy H Mathew 1, Olivia Corso1, Marie Ludlow 1, Adam Boyle 1, Alan Cass 2,3, Steven J Chadban 3,4, Beres Joyner5, Mark Shephard6 and Tim Usherwood 3
Abstract - The pilot program Kidney Evaluation for You (KEY) was conducted in Australia to screen for chronic kidney disease (CKD). Targeting people at high risk (those with diabetes, hypertension, a first-degree relative with kidney failure, or age >50 years) aimed to establish community-based screening protocols, assess efficacy in promoting changes in risk-factor management, and explore participant CKD awareness. KEY offered free cardiovascular and kidney checks using point-of-care testing for on-site pathology measurements (estimated glomerular filtration rate, hemoglobin A1c, cholesterol, hemoglobin, albuminuria), lifestyle assessment, and exit interviews. Participants were telephoned at 3 months to ascertain whether KEY advice had been followed. Community and health professional support was strong; 99% of participants rated involvement as beneficial. Of 402 high-risk individuals recruited, findings were suggestive of CKD in 20.4%. Of these, 69% had hypertension, 30% diabetes, and 40% elevated total cholesterol. All participants with CKD stage 3b or higher were aged >61 years. Overall, 58% of participants were referred to their primary care providers for further action; of these, 82% saw their doctors in the next 3 months and 94% discussed their results. Follow-up telephone contact was successful for 82% of participants. A change in management occurred for 67%. Thus, the KEY approach to early detection of CKD and selected referral of participants was largely successful.
Correspondence: Timothy H Mathew, 25 North Tce, Hackney, Sth Australia 5069 Australia tim.mathew@kidney.org.au
1 Kidney Health Australia, Adelaide, Sth Australia
2 George Institute for International Health, Sydney Australia
3 University of Sydney, New South Wales, Sydney Australia
4 Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney Australia
5 Department of Rehabilitation and Aged Care, Central Queensland Health District, Queensland Australia
6 Community Point-of-Care Services, Flinders University Rural Clinical School, South Australia
Review article: Early detection of chronic kidney disease in Australia: Which way to go?
NEPHROLOGY 2009; 14, 367–373 doi:10.1111/j.1440-1797.2009.01113.x
Dr Timothy Mathew1 and Miss Olivia Corso2
1 Kidney Health Australia, Medical Section, Kent Town Sth Australia
2 Kidney Health Australia, Health Services, Adelaide Sth Australia
Kidney Health Australia conducted a 12-month pilot study on CKD, with funding from BHP Billiton and Commonwealth Department of Health and Ageing. The KEY Health Check was launched in February 2008 and recruited over 400 participants from three diverse Australian communities (Townsville, Roxby Downs, and Perth) who were offered a free and comprehensive evaluation of kidney function, cardiovascular health and diabetes risk.
 The KEY Health Check, conducted by registered nurses and health professionals, involves blood analysis, urinalysis and body measurements. Importantly all results were available on the spot to participants as the KEY point-of-care suite is set up in a sequential order, making pathology reporting efficient.
At risk KEY participants were also followed up three months after participation to track their progress. Participants receive a one-on-one consultation with a registered nurse where they are:
- educated on diet and lifestyle choices
- provided with preventative health information
- referred to a health professional for long term management if identified as being at risk
Updated 1 July 2010
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