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Between 2005 and 2008, the rate of treated end stage kidney disease (ESKD) among people with diabetes fell from 8 to 6 per 1,000 people.

Between 2004 and 2005 the prevalence of treated ESKD among Indigenous Australians with diabetes rose, and was more than 6 times as high as among non-Indigenous Australians.

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 the proportion of people 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 prevalence 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 5,697 cases of treated ESKD amongst people with diabetes in Australia, equating to 0.6% of Australians with diabetes.

Between 2005 and 2008, the rate of treated ESKD amongst people with diabetes:

  • Fell from 8 to 6 per 1,000 people with diabetes (Figure 1).
  • Was higher among males than females.

Figure 1: Rate of treated ESKD among people with diabetes, 2005 to 2008

Indicators - prevalence rate of eskd GIF

Note: Directly age-standardised to the ABS NHS 2004–05 diabetes population.

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

Aboriginal and Torres Strait Islander people

In 2005 there were 766 (2.6%) Aboriginal and Torres Strait Islander people with treated ESKD who also had diabetes.

Between 2004 and 2005, the age-standardised proportion of people with diabetes and treated ESKD:

  • rose among Indigenous Australians (from 30.3 to 34.8 per 1,000 people) and non-Indigenous Australians (from 5.3 to 6.0 per 1,000 people) with diabetes.
  • was almost 6 times as high among Indigenous Australians as non-Indigenous Australians with diabetes.

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 2004–05 and 2007–08 (reissue) Australian Bureau of Statistics (ABS) National Health Survey (NHS) (ABS cat. no. 4634.0), 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 cases of treated ESKD per 1,000 population with diabetes.

In each of these population groups:

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

the rates compare

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

Are there any data limitations?

  • Currently, data only exist to calculate rates of ESKD among the general population and Aboriginal and Torres Strait Islander people but not other population groups of interest.
  • 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 2004–05 NHS, 2007–08 NHS and the 2004–05 NATSIHS are surveys which rely on self-reporting for health conditions.

Definitions

Prevalence is defined as the number of people who are diagnosed with a condition at a given time.

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 ABS NHS 2004–05 and 2007–08 (Reissue) 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

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
NHS
National Health Survey