Hospitalisations for dialysis
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In 2023–24, 1.7 million (14%) hospitalisations in Australia were for dialysis.
The number of hospitalisations for dialysis nearly tripled between 2000–01 and 2023–24, from 582,000 to 1.7 million.
Variation by priority population groups
Dialysis hospitalisation rates were 4.8 times as high in Remote and very remote areas as in Major cities. This disparity was greater among females than males.
Dialysis is the most common reason for hospitalisation in Australia, accounting for 14% of all hospitalisations in 2023–24 (1.7 million hospitalisations). Although the majority of people admitted to hospital for dialysis receive haemodialysis, a small number receive peritoneal dialysis. Data on this web page includes hospitalisations for both types of dialysis.
Hospitalisation data count the number of dialysis episodes rather than the number of people who receive dialysis. Most people undergoing dialysis attend 3 sessions per week (ANZDATA 2021).
Linked hospital data available in the National Health Data Hub (NHDH) was used measure the number of people who were represented by public hospital separations with a principal diagnosis of dialysis. In 2023–24, 1.2 million public hospital separations for dialysis, represented just 13,200 people. This corresponds to an average of 91 hospital separations for dialysis per person (separation to person ratio) for the year. The separation to person ratio was lowest for people 0–25 years (63 separations for dialysis per person) and highest for people aged 85 and older (105 separations per person).
For more information, see Measuring separation to person ratios using linked data from NHDH.
For more information about people receiving dialysis, see Dialysis.
Dialysis is an artificial way to remove waste and excess water from the blood, and regulate safe levels of circulating agents (such as potassium, calcium and phosphorous) in the body, a function usually performed by the kidneys. It is most often provided to treat chronic kidney failure, but is sometimes needed in cases of acute kidney failure, where the kidneys have been temporarily damaged due to illness or injury.
There are 2 types of dialysis: peritoneal dialysis and haemodialysis.
Peritoneal dialysis is an internal filtration process requiring the placement of a catheter (a thin, flexible plastic tube) into the abdomen, which remains in place as long as dialysis is required. Peritoneal dialysis uses the peritoneal membrane inside the abdominal cavity to filter the blood inside the body.
The process involves filling the abdomen with a sterile dialysis solution, called dialysate. Over 4–8 hours, waste is drawn out of the blood through the peritoneal membrane and into the dialysate. The used solution is then drained out of the body and replaced with a new solution. This process is called an exchange and takes around 30–45 minutes.
Between exchanges, the person is free to continue their usual activities. Peritoneal dialysis can be performed either by the person 3 or 4 times during the day (continuous ambulatory peritoneal dialysis) or automatically by a machine at night for about 8–10 hours while the person sleeps (automated peritoneal dialysis).
As the necessary equipment is portable, peritoneal dialysis can be performed almost anywhere. Individuals do not need to be in a hospital or clinic and can usually manage the procedure without assistance.
Haemodialysis is an external filtration process where the blood is diverted from the body to a machine which removes waste and excess fluid. It involves an initial procedure to join an artery and vein together with either a fistula or graft, that serves as the access point to the dialysis machine (dialyser). Once this access point is ready, haemodialysis sessions take place for an average of 4 to 5 hours 3 times per week (ANZDATA 2021). Once the blood has been filtered by the dialyser, it is returned to the body through the access point.
Haemodialysis can be done at home or in specialised dialysis centres located either in hospitals or satellite units. The process involves specialised plumbing installation for the dialyser and the person requires assistance to be connected to the machine. If performed at home, the procedure may be done more frequently for shorter periods or overnight.
Sources: KHA 2016a, 2016b.
Variation by age and sex
In 2023–24, hospitalisation rates for dialysis as the principal diagnosis:
- were 1.6 times higher in males than in females, after adjusting for differences in the age structure of the population groups. Age-specific rates for males were higher than those for females across all age groups older than 24.
- increased with age up to ages 75–84, with 75% of hospitalisations occurring in people aged 55 and over. Dialysis hospitalisation rates for males and females were highest among those aged 75–84 (36,100 and 17,200 per 100,000 population, respectively) (Figure 1).
Figure 1: Dialysis hospitalisation rates, as a principal diagnosis, by age and sex, 2023–24
In 2023–24, the hospitalisation rates for dialysis as the principal diagnosis was highest for males aged 75-84 years
| Age group | Male | Female | Persons |
|---|---|---|---|
| 0–24 | 181.0 | 184.0 | 182.4 |
| 25–34 | 1,661.1 | 1,346.3 | 1,504.3 |
| 35–44 | 3,424.5 | 2,718.9 | 3,069.0 |
| 45–54 | 8,886.2 | 5,908.0 | 7,376.0 |
| 55–64 | 15,064.1 | 9,953.8 | 12,451.4 |
| 65–74 | 20,974.1 | 13,705.9 | 17,188.6 |
| 75–84 | 36,065.7 | 17,173.7 | 26,088.2 |
| 85+ | 26,901.9 | 8,861.7 | 16,075.6 |
Source:
AIHW National Hospital Morbidity Database
Trends over time
The number of hospitalisations for dialysis increased 3-fold between 2000–01 and 2023–24, from 582,000 to 1.7 million. After adjusting for changes in the age structure of the population over this time, this equated to an increase of 79% in the rate of dialysis hospitalisations. Note that this does not capture trends in dialysis performed outside of hospitals.
The rate of hospitalisations for dialysis among males was consistently higher than for females over the period, with both showing similar respective rates of increase.
Variation by priority population groups
In 2023–24, hospitalisation rates for dialysis (as the principal diagnosis) varied by remoteness and socioeconomic area (Figure 2).
After adjusting for differences in the age structure of the population groups:
- dialysis hospitalisation rates were 4.8 times as high in Remote and very remote areas as in Major cities. This disparity was greater among females than males (8.6 times and 2.7 times as high, respectively)
- hospitalisations for dialysis were 2.9 times as high for people living in the lowest socioeconomic area as for those living in the highest socioeconomic area. This disparity was greater among females than males (3.7 times and 2.4 times as high, respectively).
For information for Aboriginal and Torres Strait Islander (First Nations) people, see First Nations People.
Data disaggregated by priority population groups are available in the supplementary data tables.
Figure 2: Dialysis hospitalisation rates, as a principal diagnosis, by population group and sex, 2023–24
People living in remote and very remote areas have the highest age-standardised rate dialysis hospitalisation of the selected priority population groups presented
| Remoteness area | Male | Female | Persons |
|---|---|---|---|
| Major cities | 6,716.9 | 3,663.8 | 5,087.8 |
| Inner regional | 5,905.2 | 2,992.1 | 4,397.3 |
| Outer regional | 7,295.3 | 5,805.9 | 6,538.6 |
| Remote and very remote | 18,310.1 | 31,387.8 | 24,428.8 |
| Socioeconomic group | Male | Female | Persons |
|---|---|---|---|
| Group 1 (most disadvantaged) | 10,411.8 | 8,029.7 | 9,166.1 |
| Group 2 | 7,207.5 | 4,549.7 | 5,826.7 |
| Group 3 | 6,047.2 | 3,313.4 | 4,603.8 |
| Group 4 | 5,794.4 | 2,920.7 | 4,269.0 |
| Group 5 (least disadvantaged) | 4,382.0 | 2,163.0 | 3,196.2 |
Note: Age-standardised to the 2001 Australian Standard Population.
Source:
AIHW National Hospital Morbidity Database
ANZDATA (Australia and New Zealand Dialysis and Transplant Registry) (2021) ANZDATA 44th Annual Report 2021, ANZDATA website, accessed 30 June 2022.
KHA (Kidney Health Australia) (2016a) An introduction to haemodialysis, KHA, Melbourne, accessed 22 February 2022.
KHA (2016b) An introduction to peritoneal dialysis, KHA, Melbourne, accessed 22 February 2022.