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 CKD hospitalisations, unless otherwise stated.
For more information, see Hospitalisations for dialysis.
In 2020–21, 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 2020–21. After excluding all hospitalisations where dialysis was recorded as the principal diagnosis, CKD hospitalisations accounted for 3.3% of all hospitalisations in Australia in 2020–21.
- there were around 58,200 hospitalisations with CKD as a principal diagnosis – the diagnosis largely responsible for hospitalisation
- there were around 333,000 hospitalisations with CKD as an additional diagnosis – a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management
- on average, people hospitalised with a principal diagnosis of CKD (excluding dialysis as a principal diagnosis) stayed 2.8 days in hospital. For people who required hospitalisation for one night or more, the average length of stay was 4.8 days.
Chronic kidney disease 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 2020–21 was ‘chronic kidney disease’, followed by ‘kidney tubulo-interstitial diseases’ (Table 1).
Table 1: Major causes of hospitalisation for chronic kidney disease (as the principal diagnosis), 2020–21
|Major cause of hospitalisation
|Chronic kidney disease
|Kidney tubulo-interstitial diseases
|Other disorders of kidney and ureter
|Complications related to dialysis and transplant
|Hypertensive kidney disease
|Unspecified kidney failure
|Dialysis (excluding preparatory care)
| Peritoneal dialysis
|Preparatory care for dialysis
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 2020–21 when CKD was listed as an additional diagnosis were:
- heart failure: 20,600 hospitalisations (6.2%)
- type 2 diabetes: 12,100 hospitalisations (3.6%)
- sepsis (blood poisoning): 11,500 hospitalisations (3.5%)
- acute kidney failure: 10,600 hospitalisations (3.2%)
- acute myocardial infarction (heart attack): 7,200 hospitalisations (2.2%).
CKD is often comorbid with cardiovascular disease and diabetes. In 2020–21, cardiovascular diseases (also known as circulatory diseases) were the most common type of principal diagnosis when CKD was an additional diagnosis, accounting for 18% (60,600) of these hospitalisations. Endocrine diseases, including type 1 and type 2 diabetes, accounted for 8.1% of hospitalisations where CKD was an additional diagnosis.
Injuries were also common principal diagnoses when CKD was an additional diagnosis (10.8% or 35,900 of these hospitalisations). Of these, complications associated with cardiac and vascular prosthetic devices, implants and grafts (6,200 hospitalisations) and fractures of the femur (5,300 hospitalisations) were the most common reasons for hospitalisation (Table 2).
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).
Table 2: Leading principal diagnoses when chronic kidney disease was an additional diagnosis, by ICD-10-AM chapter and code, 2020–21
||Percentage of hospitalisations where CKD was an additional diagnosis
|Diseases of the circulatory system
|Heart failure (I50)
|Acute myocardial infarction (heart attack) (I21)
|Cerebral infarction (ischemic stroke) (I63)
|Injury, poisoning and certain other consequences of external causes
|Complications of cardiac and vascular prosthetic devices, implants and grafts (T82)
|Fracture of femur (S72)
|Complications of procedures, not elsewhere classified (T81)
|Diseases of the genitourinary system
|Acute kidney failure (N17)
|Other disorders of the urinary system (N39)
|Obstructive and reflux uropathy (N13)
|Endocrine, nutritional and metabolic diseases
|Type 2 diabetes (E11)
|Other disorders of fluid, electrolyte and acid-base balance (E87)
|Type 1 diabetes (E10)
|Diseases of the digestive system
|Other diseases of the digestive system (K92)
|Paralytic ileus and intestinal obstruction without hernia (K56)
Note: Excludes chronic kidney disease as a principal diagnosis and diagnoses of ‘Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified’.
Source: AIHW National Hospital Morbidity Database.
Variation by age and sex
In 2020–21, the number of CKD hospitalisations increased with age, with 70% occurring in those aged 65 and over. CKD hospitalisation rates (as a principal or additional diagnosis, excluding dialysis as a principal diagnosis):
- were between 1.2 and 2.0 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 (19,000 and 11,200 per 100,000 population, respectively) – 1.8 and 1.7 times as high as males and females aged 75–84 (10,800 and 6,600 per 100,000, respectively) (Figure 1).
Figure 1: Chronic kidney disease hospitalisation rates, by diagnosis type, age and sex, 2020–21