Chronic kidney disease

Chronic kidney disease (CKD) contributed to 11% of all deaths in 2018 (around 16,800 deaths), according to the Australian Institute of Health and Welfare National Mortality Database. CKD was the underlying cause of death in around 3,600 deaths (21% of CKD deaths). It was an associated cause of death in a further 13,200 deaths (79% of CKD deaths). 

Trends

Age-standardised rates for CKD as the underlying or associated cause of death remained relatively stable between 1998 and 2015, followed by a decline to 2018. 

On average, CKD was the underlying or associated cause of death in around 13,700 deaths per year between 1998 and 2018. This equates to death rates of 66–80 per 100,000 population for males and 42–48 per 100,000 for females (Figure 1).

Figure 1: Trends in CKD deaths (underlying or associated cause), by sex, 1998 to 2018

Age and sex

In 2018, CKD death rates (as the underlying or associated cause):

• were 1.6 times higher among males than females (66 and 42 deaths per 100,000 population, respectively). Age-specific rates for males were higher than females across all age groups.
• increased with age, with over half (51%) of CKD deaths occurring in people aged 85 and over. CKD death rates for males and females were highest in the 85 and over age group (2,100 and 1,500 per 100,000, respectively)―at least 4 times as high for males and females aged 75–84 (516 and 303 per 100,000, respectively) (Figure 2).

Figure 2: CKD death rates (underlying or associated cause), by age group and sex, 2018

Variations between population groups

CKD death rates (as the underlying or associated cause of death) increased with remoteness and socioeconomic disadvantage. The rates were:

• almost twice as high in Remote and very remote areas compared with Major cities (99 and 52 per 100,000 population, respectively between 2016–2018). The difference in these death rates was greater for females than males—2.4 times as high for females (97 and 41 per 100,000) and 1.6 times as high for males (103 and 68 per 100,000).
• almost twice as high in the lowest socioeconomic group compared with the highest socioeconomic areas (70 and 38 per 100,000, respectively in 2018). This difference was similar for males and females (Figure 3).

Figure 3: CKD death rates (underlying or associated cause), by remoteness and socioeconomic area, 2016–2018

Aboriginal and Torres Strait Islander people

Between 2016–2018, there were 1,500 CKD-related deaths (as the underlying and/or associated cause) among Indigenous Australians, with a rate of 72 per 100,000 population (includes New South Wales, Queensland, Western Australia, South Australia and Northern Territory only).

After adjusting for differences in the age structure of the populations:

• The death rate among Indigenous Australians was almost 4 times as high as for non-Indigenous Australians (186 and 52 per 100,000, respectively).
• This disparity was higher for females than males― over 4 times as high for Indigenous females (186 and 41 per 100,000, respectively) and 3 times as high for Indigenous males (189 and 66 per 100,00, respectively).

Diseases commonly listed as underlying causes of death for CKD

CKD is often listed as an associated cause when other conditions are the underlying cause of death. In 2018, there were 13,200 deaths where CKD was recorded as an associated cause of death.

CKD was most commonly listed as an associated cause of death for deaths due to:

• diseases of the circulatory system (37%)—mostly coronary heart disease (19%) and other forms of heart disease (11%),
• cancers (19%)
• diseases of respiratory system (8.8%)—mostly chronic obstructive pulmonary disease (3.9%) and pneumonia (2.0%)
• endocrine, nutritional and metabolic diseases (8.8%)—mostly type 2 diabetes (3.7%) and unspecified type of diabetes (2.7%).