How many Australians have chronic kidney disease?

All chronic kidney disease

An estimated 1.7 million (10%) Australian adults aged 18 years and over had biomedical signs of chronic kidney disease (CKD) in 2011–12, based on measured data from the Australian Bureau of Statistics (ABS) 2011–12 Australian Health Survey. The vast majority of these (97%) showed early signs of the disease (stages 1–3). CKD remains a highly under-diagnosed condition―only 10% of the survey respondents who showed biomedical signs of CKD also self-reported that they had the condition. Therefore, this section reports measured data from the ABS 2011–12 Australian Health Survey instead of self-reported data from the more recent ABS 2017–18 National Healthy Survey.

In 2011–12, the prevalence of biomedical signs of CKD among adults:

  • was similar for men and women (10% for both)
  • increased rapidly after age 74, with rates among those aged 75 and over (42%) twice as high as for those aged 65–74 (21%) and around 7 times as high compared with those aged 18–54 (6%) (Figure 1).

Figure 1: Prevalence of CKD, among people aged 18 and over, by age and sex, 2011–12

This bar chart shows the increase in the prevalence of chronic kidney disease in 2011-12 by age group.  The prevalence of chronic kidney disease was higher for males than females in all groups, except for the 18-44 year age group where females (6%25) had a higher prevalence than males (4.5%25). The prevalence increases from 9%25 for males and 6%25 for females in the 55-64 years age group, to 26%25 for men and 16%25 for females in the 65-74 years age group, increasing again to 43%25 for men and 42%25 for females in the 75+ age group.

Note: Based on biomedical data (eGFR and ACR results).

Chart: AIHW. Source: AIHW analysis of the ABS Microdata: Australian Health Survey, Core Content—Risk factors and Selected Heath Conditions, 2011–12. (Data table)

Change over time

Between 1999–2000 and 2011–2012, the CKD prevalence rate remained stable, at around 10% among adults aged 25 and over. There was no difference between men and women in the prevalence of CKD in both surveys. The number of Australians with a moderate to severe loss of kidney function (stages 3–5) nearly doubled over this period (from 322,000 in 1999–2000 to 604,000 in 2011–12) (AIHW 2018). This increase was mostly driven by an increase in CKD stage 3 due to growth in the size of the population aged 65 and over.

Variation among population groups

In 2011–12, the prevalence of biomedical signs of CKD among adults was similar by remoteness and generally increased with socioeconomic disadvantage (Figure 2). Proportions were:

  • similar between Major cities (10%), Inner regional (11%) and Outer regional and remote (9%) areas
  • highest in the lowest socioeconomic group (14%) compared with those in the highest socioeconomic group (8%).

Figure 2: Prevalence of CKD, among persons aged 18 and over, by remoteness and socioeconomic group, 2011–12

This bar chart shows that the highest SES group had the lowest hospitalisations at 8 for males and 9 for females per 100,000 population. The lowest SES group (group 1) had the highest hospitalisations with 14 for males and 13 for females per 100,000 population.

Note: Age-standardised to the 2001 Australian Standard population.

Chart: AIHW. Source: AIHW analysis of the ABS Microdata: Australian Health Survey, Core Content—Risk factors and Selected Health Conditions, 2011–12. (Data table)

Aboriginal and Torres Strait Islander people

An estimated 1 in 5 (18%) Indigenous adults (59,600 people) had biomedical signs of CKD, according to the ABS 2012–13 National Aboriginal and Torres Strait Islander Health Measures Survey.

Indigenous Australian adults were twice as likely to have biomedical signs of CKD as their non-Indigenous counterparts, respectively, after taking into account differences in the age structure of the populations.

Treated end-stage kidney disease

Information on the prevalence and incidence of people with end-stage kidney disease (ESKD) can be obtained from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). This registry includes people who receive kidney replacement therapy (KRT) in the form of a kidney transplant or dialysis, but does not contain information on those who do not receive KRT.

The following section reports the incidence and trends of new patients end stage disease receiving KRT registered in the ANZDATA.

ESKD is the most severe form of chronic kidney disease and only half of people with ESKD are actually going through KRT as other medical care strategies for patients at the end of their life are found the most suitable (AIHW 2016).

In 2016, there were 2,800 new cases of ESKD in Australia. This is 8 cases diagnosed every day, or an incidence rate of 11 cases per 100,000 population.

The leading causes of ESKD among new patients were:

  • diabetes (35%)
  • glomerulonephritis—a type of kidney inflammation (18%)
  • hypertension (14%)
  • polycystic disease—presence of multiple cysts in the kidney (6%).

Trends by age and sex

Age standardised incidence rates of treated ESKD have almost doubled from 6 persons per 100,000 population in 1989 to 11 persons per 100,000 population in 2016. This increase was greater for males, increasing from 6 cases per 100,000 population in 1989 to 14 cases per 100,000 population in 2016, than for females, increasing from 5 to 8 cases per 100,000 population from 1989 to 2016 (Figure 3). But since 2006, the incidence rate has stabilised for both males and females.

Figure 3: Trends in incidence of treated ESKD, by sex, 1989–2016

This line graph shows that since 1989, the treated incidence of ESKD has increased from 6 for males and 5 for females per 100,000 population to 14 for males and 8 for females in 2016.

Note: Age-standardised to the 2001 Australian Standard population.

Chart: AIHW. Source: AIHW analysis of the linked ANZDATA, AIHW National Mortality Database and National Death Index. (Data table)

 

In 2016, the age specific incidence rates for treated ESKD were higher for males than females across all age groups. The incidence rate in 2016 increased rapidly with age for males, increasing by 87% from ages 55–64 to 75+. Females increased at a slower rate—49% between the age group 55–64 and 65–74 and then decreased in the 75+ age group (Figure 4).

Figure 4: Incidence of treated ESKD, by age and sex, 2016

The incidence of treated ESKD was consistently higher for males than females. The incidence increased for males from 27 per 100,000 population in the 55-64 years age group to 51 per 100,000 population in the 75+ age group. Females increased from 16 per 100,000 population in the 55-64 years age group to 24 in the 65-74 years age group. The incidence of treated ESKD then decreased to 17 per 100,000 population in the 75+ age group.

Chart: AIHW. Source: AIHW analysis of the ANZDATA. (Data table)

Variation among population groups

In 2012–2016, the incidence of treated cases of ESKD increased with remoteness and socioeconomic disadvantage.

After adjusting for difference in age structure between population groups, the incidence rates were:

  • twice as high in Remote and very remote areas compared with Major cities—at least 6 times as high for females (40 compared with 7 per 100,000 population) and almost twice as high for males (26 compared with 14 per 100,000) (Figure 5).
  • 1.5 times as high in the lowest socioeconomic group compared with the highest socioeconomic group—twice as high for females (12 compared with 6 per 100,000) and 1.3 times as high for males (17 compared with 13 per 100,000) (Figure 5).

Figure 5: Incidence of treated ESKD, by remoteness and socioeconomic group, 2012–2016

Remote and very remote areas have a higher incidence of treated ESKD (41 for females and 26 for males per 100,000 population) than major cities (14 for males and 7 for females).

Note: Age-standardised to the 2001 Australian Standard population.

Chart: AIHW. Source: AIHW analysis of the ANZDATA. (Data table)

Aboriginal and Torres Strait Islander people

In 2012–2016, the incidence rate of treated ESKD was 39 per 100,000 among the Indigenous Australians. After adjusting for difference in the age structure of the populations:

  • The rate among Indigenous Australians was 7 times higher than for non-Indigenous Australians.
  • The disparity between Indigenous Australians and non-Indigenous Australians was greater for females than males—at least 11 times as high for females and 5 times as high for males.

References

AIHW (Australian Institute of Health and Welfare) 2016. Incidence of end-stage kidney disease in Australia 1997–2013. Cat. no. PHE 211. Canberra: AIHW.

AIHW 2018. Chronic kidney disease prevalence among Australian adults over time. Cat. no. CDK 6. Canberra: AIHW.