• issue no. 34, November 2012
• previous issues

Report profiles

Dialysis and kidney transplantation in Australia: 1991–2010

Summary

End-stage kidney disease (ESKD) is a serious and costly health problem in Australia that usually requires kidney replacement therapy (KRT) for patients to survive. This therapy involves dialysis or kidney transplantation. Regional, sex and age differences influence the number of people starting and currently receiving KRT and the types of treatment used.

This report provides a detailed picture of KRT treatment in Australia using a variety of data sources. Differences are explored in KRT treatment rates and treatment patterns for ESKD between population groups and over time.

The number of people starting treatment for ESKD has increased

From 1991 to 2009, the rate of new cases of treated ESKD increased by 80%, largely due to an increase in diabetes-related cases.

More people are receiving kidney replacement therapy

Between 1991 and 2009, the number of people receiving KRT for their ESKD almost tripled, from 6,643 to 18,267.

Kidney transplantation

From 1991 to 2009, the number of transplants performed each year increased from 470 to 772, largely due to a rise in donations from living donors.

At the end of 2009, about 40% of treated-ESKD patients living in non-remote areas had a functioning kidney transplant. This compares with 9% in Remote areas and 26% in Very Remote areas.

Dialysis treatment

From 1991 to 2009, the number of people receiving dialysis tripled, from 3,138 people to 10,431.

The increase in the number of dialysis patients has resulted in an average increase of nearly 60,000 hospitalisations per year for dialysis from 2000–01 to 2009–10.

Treatment rates

For the period 2003–2007, for every new case of ESKD who received KRT, there was about one case that did not.

The vast majority (80%) of the new cases of ESKD who did not receive KRT were aged over 70.

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Insulin pump use in Australia

Summary

This report examines the use of insulin pumps by people with Type 1 diabetes. It represents the most up-to-date national reporting of this information in Australia. The findings are based on administrative data supplied by Diabetes Australia and data from the Insulin Pump User Survey, conducted by the Australian Institute of Health and Welfare in 2011.

Pump users

• As at 30 June 2011, there were 10,510 insulin pump users in Australia—representing 10% of people with Type 1 diabetes.
• Almost half of all insulin pump users were under 25 years old.
• Compared with the national average of 10%, the Australian Capital Territory (15%), Western Australia (12%) and Tasmania (11%) had a higher proportion of pump users among people with Type 1 diabetes, while the Northern Territory had the lowest proportion (7%).
• Insulin pump use was more common among people with Type 1 diabetes living in areas of high socioeconomic status (14%) than among those in low socioeconomic status areas (6%).

How have things changed?

• The number of people with Type 1 diabetes commencing insulin pump therapy increased from 107 per month in 2004 to 140 per month in 2010.
• People with Type 1 diabetes now begin using insulin pump therapy relatively sooner after diagnosis than in the past. In 1997, less than 1% began using an insulin pump within 2 years of diagnosis; in 2009, this had risen to 18%.

Financing insulin pump use

• Approximately 80% of insulin pump users with Type 1 diabetes obtained a private health insurance rebate for the purchase of their pump.
• Insulin pump therapy is more expensive than multiple daily injections. The pump itself costs between $4,000 and $9,000 and the average expenditure on consumables was $29 per month in 2010–11, compared with $6 per month for injection therapy.

Insulin pump use experience

• The largest motivating factor for choosing to use a pump was better control of diabetes—88% of survey respondents indicated this.
• For most insulin pump users, the benefits of pump use outweighed any problems they encountered.
• The fact that insulin pump therapy fitted in with the lifestyle of the user was the most frequently cited benefit (86% of survey respondents). The most commonly cited problem was that insulin pump consumables were too expensive (32%).
• Twenty-three per cent of survey respondents attended an emergency department or were admitted to hospital for diabetes management while using a pump.
• In spite of recommendations for contact with a diabetes health professional every 3–6 months, 10% of insulin pump users had not had contact with a professional in over 6 months.