Chronic kidney disease: Australian facts

Data presented in this section are based on single episodes of care, including multiple hospitalisations experienced by the same individual. Because people receiving dialysis are admitted for this purpose multiple times a week, hospitalisations involving dialysis as the principal diagnosis are not included in analyses of chronic kidney disease (CKD) hospitalisations, unless otherwise stated.

For more information, see Hospitalisations for dialysis.

In 2023–24, approximately 2 million hospitalisations (17% of all hospitalisations in Australia) recorded chronic kidney disease (CKD) (including dialysis) as a principal and/or additional diagnosis.

Dialysis accounted for 80% of CKD hospitalisations in 2023–24. After excluding hospitalisations where dialysis was recorded as the principal diagnosis, CKD hospitalisations accounted for 3.4% of all hospitalisations in Australia in 2023–24.

In 2023–24:

• there were around 68,000 hospitalisations with CKD as a principal diagnosis – the diagnosis largely responsible for hospitalisation.
• there were around 358,000 hospitalisations with CKD as an additional diagnosis – a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management.

Chronic kidney disease (CKD) is a broad term that includes multiple conditions that affect kidney function, any of which might be recorded as the principal diagnosis causing hospitalisation. The most commonly recorded principal diagnosis for CKD in 2023–24 was ‘chronic kidney disease’, followed by ‘kidney tubulo-interstitial diseases’ (Table 1).

Source: AIHW National Hospital Morbidity Database.

Chronic kidney disease hospitalisations as a principal or additional diagnosis

When CKD affects patient care during hospitalisation – but is not the principal diagnosis – it is recorded as an additional diagnosis. Except where dialysis is the principal diagnosis, CKD is more often coded as an additional diagnosis.

The leading principal diagnoses in 2023–24 when CKD was listed as an additional diagnosis were:

• heart failure: 18,300 hospitalisations (5.1%)
• type 2 diabetes: 12,800 hospitalisations (3.6%)
• acute kidney failure: 11,800 hospitalisations (3.3%)
• sepsis (blood poisoning): 9,600 hospitalisations (2.7%).

CKD is often comorbid with cardiovascular disease. In 2023–24, cardiovascular diseases (also known as circulatory diseases) were the most common type of principal diagnosis when CKD was an additional diagnosis, accounting for 16% (58,900) of these hospitalisations.

Injury, poisoning and certain other consequences of external causes were also common principal diagnoses when CKD was an additional diagnosis (10.2% or 36,700 of these hospitalisations). Of these, complications associated with cardiac and vascular prosthetic devices, implants and grafts (5,900 hospitalisations) were the most common reasons for hospitalisation.

CKD is associated with an increased risk of fractures, due to disturbances in mineral and bone metabolism as a result of the disease (Moe et al. 2006). Progression or development of kidney disease is also a risk associated with surgery, due to an increase in creatinine following surgery (Ishani et al. 2011).

Variation by age and sex

In 2023–24, the number of CKD hospitalisations increased with age, with 71% occurring in those aged 65 and over. CKD hospitalisation rates (as a principal or additional diagnosis, excluding dialysis as a principal diagnosis):

• were between 1.3 and 2.2 times higher for females than males before the age of 45. From age 45, rates were higher for men than women
• were highest in those aged 85 and over for both males and females (18,800 and 11,700 per 100,000 population, respectively) – 1.8 times as high as males and females aged 75–84 (10,200 and 6,400 per 100,000, respectively) (Figure 1).

Variation by priority population groups

In 2023–24, CKD hospitalisation rates (as the principal or additional diagnosis, excluding dialysis as a principal diagnosis) increased with remoteness and socioeconomic disadvantage.

After adjusting for differences in the age structure of the population groups, CKD hospitalisation rates were:

• 3.2 times as high for people living in Remote and very remote areas as for people living in Major cities. This disparity was higher among females than males (4.8 compared with 2.1 times as high, respectively).
• 2.3 times as high for people living in the lowest socioeconomic areas compared with those living in the highest socioeconomic areas. This disparity was higher among females than males (2.7 compared with 2.0 times as high, respectively) (Figure 2).

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.

Trends for chronic kidney disease hospitalisation as a principal diagnosis

The number of hospitalisations for CKD as a principal diagnosis (excluding dialysis as a principal diagnosis) more than doubled between 2000–01 and 2023–24, from 25,200 to 68,000 hospitalisations. Over this period, the age-standardised rate rose by 72% (Figure 3).

Supplementary chronic condition codes

CKD (stages 3 to 5) can be recorded in hospitalisation data as a supplementary code, as opposed to a principal or additional diagnosis. Supplementary codes represent a selection of clinically important chronic conditions that are part of the patient’s current health status on admission which do not meet criteria for inclusion as additional diagnoses but may affect clinical care.

• In 2023–24, CKD (stages 3 to 5) was assigned in 1.9% of hospital admissions.
• When the supplementary code for CKD was introduced in 2015–16, the number of hospitalisations recording CKD as an additional diagnosis fell (AIHW 2023).