Risk factors for chronic kidney disease

Chronic kidney disease (CKD) shares many common risk factors with cardiovascular disease (CVD) and type 2 diabetes. Some cannot be changed, such as age, sex and genetics. The focus of this fact sheet is on modifiable risk factors - that is, those that can in some way be prevented. It is important to note that there is much overlap between these risk factors, and in some circumstances one may lead to another. Where possible, information has been presented for different population groups (such as socioeconomic status, Indigenous status and geographical location) to identify groups that may be at increased risk of these diseases.

x – there is a well-established direct association between this risk factor and the disease(s).
? – there is some evidence of an association between this risk factor and the disease(s).

Overweight and obesity

Overweight and obesity is common among Australians and rising.

• Excess weight, particularly obesity, has been well established as a risk factor for CVD, diabetes and CKD (AIHW 2009).
• In 2007–08, an estimated 66% of men and 54% of women were overweight or obese (based on measured body mass index).
• A similar proportion of males and females were obese, while a higher proportion of males were overweight but not obese.
• The percentage of adults who were overweight or obese increased in most age groups from 1995 to 2007–08 mostly due to increases in obesity rates.
• People living in areas of lower socioeconomic status were more likely to be obese, as were those living in outer regional, rural and remote areas.
• Based on self-reported data from 2004–05, a similar proportion of Indigenous and non-Indigenous males were overweight or obese (67% and 64% respectively), while a higher proportion of Indigenous females were overweight or obese than non-Indigenous females (63% compared with 46% respectively).

Note: All rates age-standardised to the 2001 Australian population.
Source: AIHW analysis of the ABS 2007–08 National Health Survey and ABS 2004–05 National Aboriginal and Torres Strait Islander Health Survey.

Physical inactivity

The majority of Australians aged 15 years or over did little or no exercise in 2007–08.

• Participation in sufficient physical activity can modify or reduce the effects of some of the risk factors for CVD, Type 2 diabetes and CKD such as obesity, high blood pressure and high cholesterol (AIHW 2009).
• Almost 70% of Australians were sedentary or undertook low levels of physical activity in 2007–08.
• People living in areas of lower socioeconomic status were more likely to have sedentary levels of physical activity, as were those living in outer regional, rural and remote areas.
• Indigenous Australians also reported higher levels of sedentary physical activity.

Note: All rates age-standardised to the 2001 Australian population.
Source: AIHW analysis of the ABS 2007–08 National Health Survey and ABS 2004–05 National Aboriginal and Torres Strait Islander Health Survey.

Poor diet

A large proportion of Australian adults are not meeting healthy eating guidelines.

• Poor diet is a risk factor for CVD, Type 2 diabetes and CKD largely through its adverse influence on body weight, particularly obesity (AIHW 2009).
• In 2007–08, 9 out of 10 Australians aged 15 and over had inadequate vegetable intake, and more than half (51%) had inadequate fruit intake, based on self-reported data.
• A higher proportion of people living in areas of lower socioeconomic status had inadequate fruit intake, however there was little difference in vegetable intake between the groups.
• Those living in outer regional, rural, and remote areas were also more likely to report inadequate fruit intake than those in major cities.
• Indigenous Australians were more likely to report having an inadequate fruit intake than non-Indigenous Australians, but a slightly higher proportion reported having an adequate vegetable intake.

Note: All rates are age-standardised to the 2001 Australian population.
Source: AIHW analysis of the ABS 2007–08 National Health Survey and ABS 2004–05 National Aboriginal and Torres Strait Islander Health Survey.

Tobacco smoking

3.3 million Australians aged 14 and over smoked daily in 2010.

• Tobacco smoking increases the risk of developing CVD, Type 2 diabetes and CKD (AIHW 2009).
• In 2010, 15% of Australians aged 14 and over were daily smokers, while a further 3% smoked weekly or less than weekly.
• Smoking rates have been declining steadily since the early 1970s, while the proportion of Australians who have never smoked is increasing.
• People living in areas with the lowest socioeconomic status were twice as likely to be smokers as people living in the highest socioeconomic status areas.
• The proportion of people who smoked was higher in Remote and Very Remote areas (28.9%) compared with Major Cities (16.8%).
• Indigenous Australians aged 15 and over were more than twice as likely to be daily smokers than non-Indigenous Australians in 2008 (45% compared with 20% respectively), based on information from the National Aboriginal and Torres Strait Islander Social Survey (NATSISS).

(a) Smoked at least 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco in their life, and reports no longer smoking.
(b) Never smoked more than 100 cigarettes (manufactured and/or roll-your-own) or the equivalent amount of tobacco.
# Statistically significant difference between 2007 and 2010.
Source: 2010 National Drug Strategy Household Survey.

Excessive alcohol

The majority of Australians aged 14 and over consumed alcohol at low risk levels in 2007.

• Long-term excessive consumption of alcohol has been found to be a risk factor for the development of CVD and CKD. High consumption of alcohol is associated with a higher risk of particular diseases. High alcohol intake (and particularly binge drinking, also known as ‘short-term risk of harm’) is associated with higher blood pressure and increased risk of death from stroke. Alcohol can also affect blood triglyceride levels, complicating the effects of high blood cholesterol where present (AIHW 2004).
• In 2007, the majority (73%) of Australians aged 14 and over consumed alcohol at levels considered low risk for long-term harm.
• Those living in areas of the lowest socioeconomic status were almost twice as likely as those in living in areas of the highest socioeconomic status to abstain from alcohol or be an ex-drinker (23% compared with 12% respectively).
• Indigenous Australians were also more likely than non-Indigenous Australians to abstain or be an ex-drinker (23% compared with 17% respectively).
• Those living in Remote and Very remote areas were less likely than those in other areas to abstain from alcohol or be an ex-drinker, and more likely to drink alcohol at risky or high risk levels.

(a) Long-term risk of harm is associated with regular daily patterns of drinking. The model used is that outlined in the 2001 Australian Alcohol Guidelines (NHMRC 2001a).
(b) For males the consumption of up to 28 standard drinks per week and for females up to 14 standard drinks per week is considered ‘Low risk’.
(c) For males 29 or more standard drinks per week and for females 15 or more standard drinks per week is considered ‘Risky or high risk’.
Source: 2007 National Drug Strategy Household Survey.

High blood pressure

Almost one-third of Australians aged 25+ had high blood pressure in 1999–2000.

• High blood pressure, or hypertension, is a major risk factor for the development of diabetes complications including cardiovascular disease, kidney disease and diabetic eye disease (AIHW 2008).
• Based on measured data from the 1999–2000 AusDiab Study, around 30% of Australians aged over 25 had high blood pressure.
• Males were more likely to have high blood pressure than females (33% compared with 27%), and this was true across all age groups.
• The proportion of people with high blood pressure was higher among those who did not complete secondary school.
• There was little difference in the proportion of those with high blood pressure between those living in urban and rural areas.

(a) Age-standardised to the 2001 Australian population.
Source: AIHW analysis of the 1999–2000 AusDiab study.

High cholesterol

Half of Australians aged 25+ had high total cholesterol levels in 1999–2000.

• High blood cholesterol is a major risk factor for coronary heart disease and ischaemic stroke, two common forms of cardiovascular disease. People with diabetes, particularly Type 2 diabetes, often have high cholesterol levels.
• Almost half (48%) of Australians aged over 25 had high total cholesterol levels based on measured data from the 1999–2000 AusDiab Study.
• Little difference was seen between different socioeconomic groups and geographic location.

(a) Age-standardised to the 2001 Australian population.
Source: AIHW analysis of the 1999–2000 AusDiab study.

Impaired glucose regulation

Around 1 in 6 Australians aged 25+ had impaired glucose regulation in 1999–2000.

• Based on measured data from the 1999–2000 AusDiab, it is estimated that about 16% of Australians aged 25 years or over had impaired glucose regulation.

Source: AIHW analysis of the 1999–2000 AusDiab study