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Between 2001 and 2008, the incidence of treated end-stage kidney disease (ESKD) among people with diabetes increased from 16 to 18 per 10,000 people.

The incidence of treated ESKD between 2001 and 2004–05 increased among Aboriginal and Torres Strait Islander Australians with diabetes.

The incidence of treated ESKD among Aboriginal and Torres Strait Islanders with diabetes is around 6 times as high as among non-Indigenous Australians with diabetes.

Why is this an important indicator for diabetes?

Diabetes is the most common cause of ESKD in Australia (McDonald et al. 2008). The purpose of this indicator is to monitor the trend in new cases of treated end-stage kidney disease (ESKD) among people with diabetes.

ESKD is a chronic disease in which the kidneys fail over time. People with ESKD require dialysis or kidney transplant to survive. Severe kidney damage can lead to ESKD (AIHW 2008). People with diabetes have a greater risk from kidney damage if they do not manage their blood glucose well. This risk also rises with high blood pressure and smoking.

This indicator shows trends in the incidence of treated end-stage kidney disease (ESKD) among people with diabetes in:

  • the general population
  • Aboriginal and Torres Strait Islander people, and
  • non-Indigenous people.

What are the results?

General population

  • In 2008, there were 1,109 new cases of treated ESKD amongst people with diabetes, equating to 0.1% of Australians with diabetes.

Between 2001 and 2008:

  • There was a general rise in the incidence of treated ESKD amongst people with diabetes: from 15.8 in 2001 to 17.9 in 2005 per 10,000 people with diabetes (Figure 1). This rate then remained stable at 17.8 per 10,000 people in 2008.
  • Males with diabetes had consistently higher incidence rates of treated ESKD compared to females with diabetes.

Figure 1: Rate of incident treated ESKD among people with diabetes, 2001 to 2008

Stacked line chart showing for males, persons, females; ESKD cases per 10,000 people on the y axis; year 2001, 2005, 2008 on the x axis.

Note: Directly age-standardised to the 2001 ABS NHS diabetes population.

Source: AIHW analysis of ANZDATA dataset; AIHW analysis of ABS NHS 2001, 2004–05 and 2007–08 (reissue).

Aboriginal and Torres Strait Islander population

In 2005, there were 171 (0.6%) new cases of ESKD among Aboriginal and/or Torres Strait Islander people with diabetes.

Between 2001 and 2005, the age-standardised incidence of treated ESKD amongst people with diabetes:

  • increased from 56.4 to 59.6 per 10,000 among Aboriginal and Torres Strait Islander Australians and from 9.0 to 10.3 per 10,000 among non-Indigenous Australians.
  • was around 6 times as high among Indigenous Australians compared with non-Indigenous Australians.

What are the data sources?

The main data sources for this indicator are:

  • ANZDATA (data from all treated ESKD patients in Australia and New Zealand)
  • The 2001, 2004–05 and 2007–08 (reissue) Australian Bureau of Statistics (ABS) National Health Survey (NHS) (ABS cat. no. 4634.0)
  • The ABS National Health Survey – Indigenous Supplement (NHS–IS) 2001 (ABS cat. no. 4715.0), and
  • The ABS National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) 2004–05 (ABS cat. no. 4715.0).

How is this indicator calculated?

The data in this indicator are directly age-standardised and presented as the number of new cases of treated ESKD (at first treatment) per 10,000 population with diabetes.

In each of these population groups:

  • all people
  • people who identify as Aboriginal and/or Torres Strait Islander
  • people who identify as non-Indigenous

the rates compare

  • numerator: the number of new cases of ESKD among people with diabetes (from ANZDATA), to
  • denominator: the number of people with diabetes (from NHS/NATSIHS)

Are there any data limitations?

  • Currently, data only exist for ESKD among the general population and Aboriginal and Torres Strait Islander people.
  • This indicator only counts people with diabetes who are being treated for end-stage kidney disease, by either dialysis or kidney transplant.
  • Indigenous status is self-reported as 'Australian Aboriginal' or 'Torres Strait Islander'. There is no non-response option.
  • The 2001 NHS, 2004–05 NHS, 2007–08 NHS, 2001 NHS–IS and the 2004–05 NATSIHS are surveys which rely on self-reporting for health conditions.

Definitions

Incidence is defined as the number of people who are diagnosed with a condition during a given period.

People with diabetes and ESKD include those with diagnosed Type 1 or Type 2 diabetes and treated end-stage kidney disease.

People with diabetes include those who self-reported having diabetes to the 2001, 2004–05 and 2007–08 (Reissue) NHS, 2001 NHS–IS and 2004–05 NATSIHS.

Indigenous status is self-reported.

Where can I find more information?

AIHW (Australian Institute of Health and Welfare) 2008. Diabetes: Australian facts 2008. Diabetes series no. 8. Cat. no. CVD 40. Canberra: AIHW.

AIHW 2007. National indicators for monitoring diabetes: report of the Diabetes Indicators Review Subcommittee of the National Diabetes Data Working Group. Diabetes series no. 6. Cat. no. CVD 38. Canberra: AIHW.

McDonald SP, Excell L & Livingston B 2008. Australian and New Zealand Dialysis and Transplant Registry Report 2008. Adelaide: ANZDATA.

Abbreviations

ABS
Australian Bureau of Statistics
AIHW
Australian Institute of Health and Welfare
ANZDATA
Australian and New Zealand Dialysis and Transplant Authority
ESKD
End-Stage Kidney Disease
NATSIHS
National Aboriginal and Torres Strait Islander Health Survey
NDSS
National Diabetes Services Scheme
NHS–IS
National Health Survey – Indigenous Supplement