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.

For more information, see What is dialysis?

Variation by age and sex

In 2020, 14,600 people with kidney failure received dialysis (8,800 males and 5,700 females).

The number of males who received dialysis was higher than the number of females in all age groups. The number was highest in the 65–74 year age group (2,300 men and 1,500 women). The number of people with kidney failure receiving dialysis reduced sharply in people aged 85 and over (Figure 1).

Figure 1: Prevalence of kidney failure with dialysis, by age and sex, 2020

The bar chart shows the number of people living with kidney failure who are being treated with dialysis in 2020, by age group and sex. More males than females were treated with dialysis across all age groups. The number of people receiving dialysis for kidney failure increased with age until peaking in the 65-74 year age group for males and females, before declining with age thereafter. This pattern was the same for males and females.

                 Download data

Trends over time

The number of people with kidney failure who received dialysis more than doubled between 2000 and 2020, from 6,400 to 14,600.

The number of males receiving dialysis in 2020 was 2.4 times as high as in 2000 (8,800 and 3,600), while the number of females receiving dialysis was 2.0 times as high (5,700 and 2,800) (Figure 2).

Figure 2: Trends in the prevalence of kidney failure with dialysis, by sex, 2000 to 2020

The line chart shows the number of people receiving dialysis, by sex, from 2000 to 2020. Overall, there has been an increase of 127% in the number of people receiving dialysis. The increase was larger for males than females (144% for males, 105% for females).

                 Download data

Dialysis type

Haemodialysis is the most common type of dialysis received by people with kidney failure.

In 2020, 83% of people with kidney failure who were receiving dialysis underwent haemodialysis, compared with 17% who used peritoneal dialysis. In 2000, the corresponding proportions were 73% using haemodialysis and 27% peritoneal dialysis (Figure 3).

Figure 3 and 3(b): Trends in prevalence of kidney failure with dialysis, by type, 2000 to 2020

The line chart shows the change in the type of dialysis people receive, from 2000 to 2020. The overall number of people receiving haemodialysis has increased dramatically, from 4,700 people in 2000 to 12,000 in 2020, or a 157% increase. In contrast, around 1,700 people received peritoneal dialysis in 2000 compared to 2,500 in 2020 (a 46% increase).

                 Download data

Dialysis treatment location

In 2020, 54% of people receiving dialysis were treated in satellite facilities, with 21% treated in hospital and 25% at home. A satellite facility has been the most common location to receive dialysis since 2002 (Figure 4); before 2002, home was the most common location.

This reflects changes in the kidney care landscape, with the expansion of satellite kidney care centres, in response to the growth of the population with kidney failure.

The number of people with kidney failure receiving dialysis has risen across all dialysis locations. From 2000 to 2020, numbers increased:

  • by 256% for satellite dialysis care, from 2,200 to 7,800
  • by 49% for home dialysis, from 2,400 to 3,700
  • by 72% for hospital dialysis, from 1,800 to 3,000.

 

Figure 4: Trends in prevalence of kidney failure with dialysis, by location, 2000 to 2020

The line chart shows the age-standardised change in the number of people receiving dialysis at satellite, home and hospital locations, from 2000 to 2020. This number has increased across all locations, however the number of people receiving dialysis in satellite facilities has increased the most, from 2,200 in 2000 to 7,800 in 2020, with 54% of people receiving dialysis doing so at satellite facilities in 2020.

                 Download data

Kidney care units in Australia

Kidney transplants and dialysis are usually performed in specialised kidney units in hospitals, satellite facilities and transplant centres. Australia has more than 100 kidney care ‘parent’ units that are typically based in hospitals, and over 300 locations for dialysis treatment (ANZDATA 2021). It is common for hospital-based units to be associated with one or more satellite units that provide access to dialysis and transplantation services, and to inpatient hospital care.

In 2019, an ANZDATA survey found that the size of kidney units varied considerably across Australia, with over half treating fewer than 250 patients, and the largest caring for well over 1,000 patients. Kidney transplantation was available in 40% of the units.

On average, each unit had 3 full-time consultant nephrology staff. Most units also had physician trainees, along with nurse practitioners, nurses, dietitians, social workers, pharmacists and transplant coordinators (McDonald et al. 2021).

References 

ANZDATA (Australia and New Zealand Dialysis and Transplant Registry) (2021) ANZDATA 44th Annual Report 2021 ANZDATA, Adelaide, accessed 1 November 2021.

McDonald S, Hewawasam E, Hurst K, Irish G and Clayton P (2021) ANZDATA special reports 1: unit survey 2020, ANZDATA, Adelaide, accessed 8 April 2022.