Chronic kidney disease and Aboriginal and Torres Strait Islander people (AIHW)

Chronic kidney disease (CKD)

There are no measured data on the overall prevalence of CKD among Indigenous Australians.
Based on self-reported data from the National Aboriginal and Torres Strait Islander Health Survey in 2004–05 an estimated 3.4% of Indigenous Australians had kidney disease as a long-term condition.
Rates of chronic kidney disease and kidney damage vary among communities.

All new cases of end-stage kidney disease (ESKD)

This section includes cases of ESKD receiving dialysis or a transplant, and those who die and do not receive these treatments.

It is estimated that over the period of 2003–2007, Indigenous Australians:

accounted for 8% of all new cases of ESKD
developed ESKD at more than 6 times the rate of non-Indigenous Australians (115 per 100,000 compared with 19 per 100,000 respectively), and
were more likely to develop ESKD in all age groups (Figure 1).

Figure 1: Total incidence of ESKD, by age and Indigenous status, 2003–2007

Bar chart shows the rate of ESKD increased with age, and Indigenous Australians developed ESKD at a higher rate than non-Indigenous Australians, across all age groups.

Note: Only New South Wales, Queensland, Western Australia, South Australia and the Northern Territory are included.
Source: AIHW (2011), End-stage kidney disease in Australia: total incidence 2003-2007. Source data

Cases of ESKD treated with dialysis or transplant

This section refers to ESKD patients registered with the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry as receiving kidney replacement therapy in the form of dialysis or kidney transplantation.

New cases of treated ESKD:

Almost 10% (476) of people commencing dialysis or transplant treatment for the ESKD in 2007–2008 identified as Indigenous Australians
Indigenous Australians commenced treatment at almost 8 times the rate of non-Indigenous Australians (79 per 100,000 compared with 10 per 100,000 population, respectively).
Rates of new cases of treated ESKD among Indigenous Australians were highest for those living in Remote and Very remote areas (Figure 2).
Between 2008 and 2020, the rate of Indigenous Australians commencing dialysis or transplant treatment for ESKD is expected to increase by 43%.

Figure 2: New cases of treated ESKD, by Indigenous status and geographical location, 2005–2008

Bar chart shows Indigenous Australians started treatment for ESKD at a greater rate than non-Indigenous Australians across all locations. Rates were highest in remote (156 per 100,000 population) and very remote areas (163 per 100,000), compared to major cities (38 per 100,000), inner regional areas (41 per 100,000) and outer regional areas (95 per 100,000).

Note: Directly age-standardised to the 2001 Australian population.
Source: AIHW analysis of ANZDATA Registry data. Source data

Treated ESKD as at 31 December 2008:

Indigenous Australians were receiving treatment for ESKD at 6 times the rate of non-Indigenous Australians
12% of Indigenous Australians with treated ESKD had a functioning kidney transplant, compared with 45% of non-Indigenous treated ESKD patients. This is due to a number of factors including the higher prevalence of comorbid conditions among Indigenous Australians which can reduce the likelihood of receiving a transplant, and increase the mortality and transplant failure rate following a kidney transplant.
Rates of treated ESKD among Indigenous Australians were highest for those living in Remote areas.

Hospitalisations

Indigenous Australians are more likely to be hospitalised for CKD than other Australians - in 2008–09, rates were 11 times as high for dialysis, and 5 times as high for other CKD hospitalisations
Hospitalisation rates were highest for Indigenous Australians living in Remote areas.

Deaths

Indigenous Australians were almost 4 times as likely to die with CKD as a cause of death than non-Indigenous Australians.

Hospital admitted patient expenditure

In 2006–07, over 12% of hospital admitted patient expenditure on CKD ($93.5 million) was for Indigenous Australians.

Expenditure per person in the population for Indigenous Australians was almost 6 times that of expenditure per person for non-Indigenous Australians ($187 compared with $33, respectively).

Tables for figures

Table for Figure 1: Total incidence of ESKD, by age and Indigenous status, 2003–2007
Age group	Indigenous	Non-Indigenous
0–29	3.7	1.5
30–39	41.0	4.2
40–49	118.9	7.9
50–59	252.2	14.0
60–69	326.9	29.8
70–79	308.7	78.9
80+	499.8	234.2

Note: Directly age-standardised to the 2001 Australian population.

New cases of treated ESKD, by Indigenous status and geographical location, 2005–2008
Region	Indigenous	Non-Indigenous
Major cities	37.9	10.8
Inner regional	40.7	9.0
Outer regional	94.9	8.7
Remote	155.8	8.4
Very remote	163.2	7.8