Treatment of kidney failure
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In 2024, 67% of new kidney failure cases were attributable to 3 causes: diabetes (36%), glomerular disease (a type of kidney inflammation) (19%) and hypertension (11%).
Incidence of kidney replacement therapy
During 2024, 3,500 people with kidney failure started kidney replacement therapy (KRT) in Australia, at an average of 9 people per day.
Prevalence of kidney replacement therapy
In 2024, 30,000 people living with kidney failure in Australia were receiving KRT (AIHW analysis of ANZDATA 2024).
This section presents statistics on the number of people with kidney failure receiving kidney replacement therapy (KRT), using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry (reporting to year 2024). Statistics on the number of people with kidney failure (treated and untreated), use the Kidney and Diabetes Data Integration (KADDI) (reporting to year 2021) – a linked data asset that includes the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and the National Death Index.
Kidney failure
Kidney failure is the most severe form of chronic kidney disease (CKD). It occurs when the kidneys can no longer function adequately on their own.
People with kidney failure require kidney replacement therapy (KRT) to survive. KRT involves either dialysis or a kidney transplant.
Not all people with kidney failure choose to undergo KRT. Instead, some opt to receive comprehensive conservative care, with a focus on quality of life and symptom control.
Whether a person chooses to receive KRT is a personal decision and may depend on factors such as age and expected quality of life with KRT compared with comprehensive conservative care. Person-centred care emphasises that decisions about the type of treatment be made collaboratively between the person with kidney failure, their family and their care team.
Comprehensive conservative care and kidney supportive care
Not all people with kidney failure undertake KRT – comprehensive conservative care and management of kidney failure is a treatment choice that focusses on patient care, quality of life and symptom control rather than on efforts to prolong life.
Kidney supportive care aims to improve the quality of life of people living with CKD, regardless of whether they are undergoing therapies intended to prolong life (Davison et al. 2015).
This care includes preventing and relieving pain and takes into account other physical, psychological, social or spiritual needs, helping people to live as actively as possible until death (WHO 2022). It emphasises shared decision-making between the person with CKD, their families and their health care team.
For a person near the end of their life, comprehensive conservative care with supportive care may be a more suitable form of care. Decisions on whether to start or withdraw from KRT are made by the person living with CKD and their family. These decisions are informed by the person’s health-care team (including their general practitioner and nephrologist); they consider people’s prognoses, as well as assessments of the person’s anticipated quality of life (with or without dialysis) and treatment burdens (AIHW 2016).
For each person who started KRT in 2021, there was one person with kidney failure who did not receive KRT.
The probability of not receiving KRT increases sharply from age 75. In 2021, the incidence of people not receiving KRT increased from 13 per 100,000 population in those aged 65–74, to 145 per 100,000 in those aged 75 and over (Figure 1).
Figure 1: Incidence of kidney failure with and without replacement therapy, by age, 2021
This figure shows that in 2021, the incidence rate of people with kidney failure without replacement therapy was highest for those aged 75 and over
| Age group | Kidney failure with replacement therapy | Kidney failure without replacement therapy |
|---|---|---|
| <55 | 5.6 | 0.4 |
| 55-65 | 22.6 | 4 |
| 65-74 | 36.7 | 13.1 |
| 75+ | 32.7 | 145.3 |
| All ages | 12.5 | 12.6 |
Source:
Kidney and Diabetes Data Integration (KADDI) project - linked data from the Australia and New Zealand Dialysis and Transplant Registry and AIHW National Mortality Database and National Death Index
Incidence of kidney replacement therapy
An estimate of the incidence of KRT can be obtained from the ANZDATA Registry. This registry includes information on people who have had KRT in the form of dialysis or a kidney transplant.
For the total incidence of kidney failure (treated and untreated), see Incidence of kidney failure.
During 2024, 3,500 people with kidney failure started KRT in Australia, at an average of 9 people per day (AIHW analysis of ANZDATA 2024).
In 2024, 67% of newly treated kidney failure cases were attributable to 3 causes: diabetes (36%), glomerular disease (a type of kidney inflammation) (19%) and hypertension (11%).
Variation by age and sex
Of the 3,500 people with kidney failure who started KRT in 2024, 53% were aged under 65 and 64% were males.
In 2024, the incidence rate of KRT:
- was 1.8 times as high in males as in females, after adjusting for age
- increased with age, to be highest in the 75–79 age group (Figure 2).
Figure 2: Incidence of kidney failure with replacement therapy, by age and sex, 2024
| Age group | Males | Females |
|---|---|---|
| 0–19 | 0.8 | 0.8 |
| 20–24 | 1.5 | 1.6 |
| 25–29 | 4.1 | 4 |
| 30–34 | 4.8 | 4.8 |
| 35–39 | 7.4 | 6.8 |
| 40–44 | 13.5 | 6.3 |
| 45–49 | 17.4 | 10.3 |
| 50–54 | 21.5 | 13.9 |
| 55–59 | 27 | 13.3 |
| 60–64 | 37.1 | 20.4 |
| 65–69 | 41.7 | 23.2 |
| 70–74 | 54.4 | 24.4 |
| 75–79 | 65.6 | 30.3 |
| 80–84 | 55.5 | 16.1 |
| 85+ | 21 | 6 |
Source:
AIHW analysis of the Australia and New Zealand Dialysis and Transplant Registry 2024
Variation by priority population groups
In 2024, the incidence rate of KRT was much higher in Remote and very remote areas and increased with socioeconomic disadvantage.
After adjusting for differences in the age structure of the populations, rates were:
- 3.8 times as high in Remote and very remote areas as in Major cities. This disparity was greater among females than males (5.9 times and 2.6 times as high, respectively).
- 2.3 times as high in the lowest socioeconomic areas as in the highest socioeconomic areas. Rates were 2.9 times as high among females, and 2.0 times as high among males. (Figure 3).
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.
Figure 3: Incidence of kidney replacement therapy, by priority population group, 2024
People living in remote and very remote areas have the highest age-standardised KRT incidence rate of the selected priority population groups presented
| Remoteness area | Males | Females | Persons |
|---|---|---|---|
| Major cities | 14.1 | 7.1 | 10.4 |
| Inner regional | 12.8 | 7.1 | 9.9 |
| Outer regional | 15.4 | 10.2 | 12.8 |
| Remote and very remote | 37 | 42.1 | 39.6 |
| Socioeconomic group | Males | Females | Persons |
|---|---|---|---|
| Group 1 (most disadvantaged) | 19.9 | 12.3 | 16 |
| Group 2 | 15.6 | 8.7 | 12.1 |
| Group 3 | 13.6 | 8.3 | 10.9 |
| Group 4 | 12 | 6.1 | 8.9 |
| Group 5 (least disadvantaged) | 10 | 4 | 7 |
Note: Age-standardised to the 2001 Australian Standard Population.
Source:
AIHW analysis of the Australia and New Zealand Dialysis and Transplant Registry 2024
Trends over time
Between 2000 and 2024 the number of people with kidney failure who started KRT rose from 1,800 to 3,500.
After adjusting for differences in the age structure of the population groups, the incidence rate of KRT has remained stable at 10 or 11 per 100,000 in the two decades from 2005 to 2024.
Prevalence of kidney replacement therapy
This section reports on the total number of people with kidney failure who received kidney replacement therapy (KRT) in Australia.
At the end of 2024, 30,000 people living with kidney failure had received KRT in Australia, of whom 61% (18,300) were males, and 70% (21,200) were aged under 70 (ANZDATA 2024).
In 2024, the prevalence rate of KRT:
- was 1.6 times as high in males as in females, after adjusting for age.
- increased with age, to be highest among men aged 75–79 (410 per 100,000 population) and women aged 65–69 (220 per 100,000 population) (Figure 4).
Figure 4: Prevalence of kidney replacement therapy, by age and sex, 2024
The prevalence of kidney failure with replacement therapy increases more steeply with age among males than females
| Age group | Males | Females |
|---|---|---|
| 0–19 | 7.9 | 4.8 |
| 20–24 | 18.1 | 15.9 |
| 25–29 | 34.8 | 24.4 |
| 30–34 | 47.9 | 34 |
| 35–39 | 68.6 | 56.1 |
| 40–44 | 99.6 | 74.9 |
| 45–49 | 156.6 | 102.3 |
| 50–54 | 213.3 | 138.7 |
| 55–59 | 267.4 | 166 |
| 60–64 | 317.5 | 189.3 |
| 65–69 | 346 | 220.4 |
| 70–74 | 375.3 | 219 |
| 75–79 | 409.7 | 202.5 |
| 80–84 | 393.1 | 161.2 |
| 85+ | 219.1 | 74.1 |
Source:
AIHW analysis of the Australia and New Zealand Dialysis and Transplant Registry 2024
Type of kidney replacement therapy
The type of KRT received varies according to age. In 2024, people with kidney failure aged under 55 were more likely to have a functioning kidney transplant than undergo dialysis (Figure 5).
Between ages 55 and 64, approximately half of the people receiving KRT had a functioning kidney transplant (51%), and half received dialysis (49%).
After age 65, people with kidney failure were more likely to receive dialysis than have a functioning kidney transplant, with the proportion of people on dialysis rising sharply from age 75.
Figure 5: Proportion of kidney replacement therapy type, by age, 2024
In 2024, the proportion of people with kidney failure who have a functioning kidney transplant decreases with age.
| Age group | Dialysis | Transplant |
|---|---|---|
| 0–24 | 27% | 73% |
| 25–34 | 38% | 62% |
| 35–44 | 41.7% | 58.3% |
| 45–54 | 44.3% | 55.7% |
| 55–64 | 49.1% | 50.9% |
| 65–74 | 55.1% | 44.9% |
| 75–84 | 76.1% | 23.9% |
| 85+ | 90.6% | 9.4% |
Source:
AIHW analysis of the Australia and New Zealand Dialysis and Transplant Registry 2024
Variation by priority population groups
In 2024, the prevalence rate of KRT was highest in Remote and very remote areas and increased with socioeconomic disadvantage.
After adjusting for differences in the age structure of the populations, rates were:
- 3.0 times as high in Remote and very remote areas as in Major cities. Rates were 4.9 times as high for females and 1.9 as high for males.
- 1.8 times as high in the lowest socioeconomic areas as in the highest socioeconomic areas. Rates were 2.0 times as high for females and 1.7 times as high for males (Figure 6).
For information for Aboriginal and Torres Strait Islander (First Nations) people, see First Nations People.
Figure 6: Prevalence of kidney replacement therapy, by priority population group and sex, 2024
People living in remote and very remote community have the highest age-standardised prevalence rate of the selected priority population groups presented
| Remoteness area | Males | Females | Persons |
|---|---|---|---|
| Major cities | 122.7 | 69.8 | 94.9 |
| Inner regional | 107.9 | 61.7 | 84.2 |
| Outer regional | 121 | 89 | 105 |
| Remote and very remote | 235 | 345.4 | 286.8 |
| Socioeconomic group | Males | Females | Persons |
|---|---|---|---|
| Group 1 (most disadvantaged) | 153.9 | 105.8 | 129.2 |
| Group 2 | 129.2 | 81.6 | 104.7 |
| Group 3 | 118.2 | 73.9 | 95.3 |
| Group 4 | 108.6 | 58.4 | 82.4 |
| Group 5 (least disadvantaged) | 92.3 | 52.1 | 71.1 |
Notes
- Age-standardised to the 2001 Australian Standard Population.
- The prevalent population includes people with kidney failure who were receiving KRT as at 31 December 2024.
- Population-based Socio-Economic Index for Areas (SEIFA) quintile derived from the Index of Relative Socioeconomic Disadvantage for records with sufficient geographic information.
Source:
AIHW analysis of the Australia and New Zealand Dialysis and Transplant Registry 2024
Trends over time
Between 2000 and 2024:
- the number of people with kidney failure receiving KRT more than doubled, from 11,700 to 30,000
- the age-standardised prevalence rate of KRT increased by 56%, increasing more among males (65%) than females (44%).
AIHW (Australian Institute of Health and Welfare) (2016) Incidence of end-stage kidney disease in Australia 1997–2013, AIHW, Australian Government, accessed 8 March 2022.
ANZDATA (Australia and New Zealand Dialysis and Transplant Registry) (2024), AIHW analysis of ANZDATA, accessed 25 February 2026.
Davison, S.N., Levin, A., Moss, A.H., Jha, V., Brown, E.A., Brennan, F., Murtagh, F.E., Naicker, S., Germain, M.J., O'donoghue, D.J. and Morton, R.L., (2015) Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care. Kidney international, 88(3), pp.447-459.
WHO (World Health Organization) (2022) Palliative care, WHO, accessed 21 February 2022.