Kidney function test—type 2 diabetes or CVD (PI18 and PI19)

Indicators related to kidney function tests in the national Key Performance Indicators (nKPI) collection are:

  • Type 2 diabetes:

    • the proportion of Indigenous regular clients aged 15 and over with type 2 diabetes who had an estimated glomerular filtration rate (eGFR) recorded and/or an albumin/creatinine ratio (ACR) or other micro albumin test result recorded within the previous 12 months
    • the proportion of Indigenous regular clients aged 15 and over with type 2 diabetes who had an eGFR recorded within the previous 12 months within a specified range
    • the proportion of Indigenous regular clients aged 15 and over with type 2 diabetes who had an ACR recorded within the previous 12 months within a specified range.
  • Cardiovascular disease (CVD):
    • the proportion of Indigenous regular clients aged 15 and over with CVD who had an eGFR recorded within the previous 12 months
    • the proportion of Indigenous regular clients aged 15 and over with CVD who had an eGFR test recorded within the previous 12 months within a specified range.

Why testing kidney function is important

Type 2 diabetes and CVD can damage the kidneys. If kidney disease is diagnosed early, appropriate treatment can be given and its effects can be closely monitored.

The Royal Australian College of General Practitioners (RACGP) guidelines recommend an annual screening of kidney function in patients with CVD and type 2 diabetes for albuminuria by ACR (spot urine sample), and annual estimation of the eGFR (RACGP 2020).

A ‘normal’ eGFR result is considered to be ≥60 mL/min/1.73 m2 (Kidney Health Australia 2020).

Very low values for ACR (<2.5 for males or <3.5 for females) generally indicate that kidney function is normal if other tests of kidney function also show no abnormality. A moderately increased ACR indicates an early phase of developing kidney disease. Very high values indicate that kidney disease is present in a more severe form.

Indigenous Australians are far more likely to develop, and to die from, chronic kidney disease than non-Indigenous Australians (AIHW 2020; Kidney Health Australia 2020).

Kidney function test recorded—type 2 diabetes or CVD (PI18)

This indicator is:

  • the proportion of Indigenous regular clients aged 15 and over with type 2 diabetes who had an eGFR and/or ACR or other micro albumin test result recorded within the previous 12 months; and
  • the proportion of Indigenous regular clients aged 15 and over with CVD who had an eGFR recorded within the previous 12 months.

It is collected for males and females in age groups from 15–24 to 65 and over. It is presented here for males and females in age groups:

  • under 35
  • 35–44
  • 45–54
  • 55–64
  • 65 and over.

At June 2021:

  • 63% of Indigenous regular clients aged 15 and over with type 2 diabetes had an eGFR recorded and/or ACR or other micro albumin test result recorded within the previous 12 months
  • 62% of Indigenous regular clients aged 15 and over with CVD had an eGFR recorded test result recorded within the previous 12 months.

Having an eGFR and/or ACR or other micro albumin test result recorded within the previous 12 months for clients with type 2 diabetes was highest in:

  • Western Australia (68%)
  • Major cities (67%)
  • Aboriginal Community Controlled Health Organisations (ACCHOs) (67%).

Having an eGFR test result recorded within the previous 12 months for clients with CVD was highest in:

  • Western Australia (68%)
  • Major cities (65%)
  • Aboriginal Community Controlled Health Organisations (ACCHOs) (64%).

Kidney function test recorded—type 2 diabetes or CVD, by test type and either state/territory, remoteness or organisation type, reporting period

Two Tableau visualisations are presented here. The first shows the percentage of Indigenous regular clients aged 15 and over with either type 2 diabetes or CVD who had a kidney function test recorded in the last year by test type for either:

  • state/territory (NSW/ACT, Vic, Qld, WA, SA, Tas, NT, Australia)
  • remoteness area (Major cities, Inner regional, Outer regional, Remote, Very remote, Australia)
  • organisation type (ACCHO, non-ACCHO, Total).

Reporting periods of either June 2017, December 2017, June 2018, December 2018, June 2019, December 2019, June 2020, December 2020, or June 2021 can be selected.

The second visualisation shows the selected information from the first visualisation by sex (male, female) and age group (<35, 35–44, 45–54, 55–64, 65+).

Data supporting this visualisation are available in Excel supplementary data tables at Data.

Kidney function test result (eGFR)—type 2 diabetes or CVD (PI19-A)

This indicator is the proportion of Indigenous regular clients aged 15 and over with type 2 diabetes or CVD who had an eGFR test result recorded within the previous 12 months of (mL/min/1.73m2):

  • ≥90
  • ≥60–<90
  • ≥45–<60
  • ≥30–<45
  • ≥15–<30
  • <15.

It is collected for males and females in age groups from 15–24 to 65 and over. It is presented here for all Indigenous regular clients aged 15 and over.

At June 2021:

  • 80% of Indigenous regular clients aged 15 and over with type 2 diabetes had an eGFR test result recorded within the previous 12 months of ≥60 mL/min/1.73m2
  • 77% of Indigenous regular clients aged 15 and over with CVD had an eGFR test result recorded within the previous 12 months of ≥60 mL/min/1.73m2.

Having an eGFR result of ≥60 mL/min/1.73m2 within the previous 12 months for clients with type 2 diabetes was highest in:

  • South Australia (84%)
  • Major cities (85%)
  • Aboriginal Community Controlled Health Organisations (ACCHOs) (81%).

Having an eGFR result of ≥60 mL/min/1.73m2 within the previous 12 months for clients with CVD was highest in:

  • Victoria/Tasmania (combined) and Queensland (both 78%)
  • Major cities (81%)
  • Aboriginal Community Controlled Health Organisations (ACCHOs) (77%).

Kidney function test result (eGFR)—type 2 diabetes or CVD, by result level and either state/territory, remoteness or organisation type, reporting period

This Tableau visualisation shows the percentage of Indigenous regular clients aged 15 and over with either type 2 diabetes or CVD who had an eGFR kidney function test result by result level in mL/min/1.73m2 (select by ≥90, ≥60–<90, ≥45–<60, ≥30–<45, ≥15–<30, or <15) for either:

  • state/territory (NSW/ACT, Vic, Qld, WA, SA, Tas, NT, Australia)
  • remoteness area (Major cities, Inner regional, Outer regional, Remote, Very remote, Australia)
  • organisation type (ACCHO, non-ACCHO, Total).

Reporting periods of either June 2017, December 2017, June 2018, December 2018, June 2019, December 2019, June 2020, December 2020, or June 2021 can be selected.

Data supporting this visualisation are available in Excel supplementary data tables at Data.

Kidney function test result (ACR)—type 2 diabetes (PI19-B)

This indicator is:

  • the proportion of male Indigenous regular clients aged 15 and over with type 2 diabetes who had an albumin/creatinine ratio (ACR) recorded within the previous 12 months of (mg/mmol):
    • <2.5
    • ≥2.5–≤25
    • >25; and
  • the proportion of female Indigenous regular clients aged 15 and over with type 2 diabetes who had an albumin/creatinine ratio (ACR) recorded within the previous 12 months with a result of (mg/mmol):
    • <3.5
    • ≥3.5–≤35
    • >35.

It is collected for males and females in age groups from 15–24 to 65 and over. It is presented here for all Indigenous regular clients aged 15 and over.

At June 2021, 43% of Indigenous regular clients aged 15 and over with type 2 diabetes had an albumin/creatinine ratio (ACR) recorded within the previous 12 months of <2.5 for males or <3.5 for females.

This was highest in:

  • New South Wales/the Australian Capital Territory (combined) (54%)
  • Inner regional areas and Major cities (both 54%)
  • Aboriginal Community Controlled Health Organisations (ACCHOs) (45%).

Kidney function test result (ACR)—type 2 diabetes, by result level and either state/territory, remoteness or organisation type, reporting period

This Tableau visualisation shows the percentage of Indigenous regular clients aged 15 and over with type 2 diabetes who had an ACR kidney function test result in the last year, select for ACR result for either:

  • state/territory (NSW/ACT, Vic, Qld, WA, SA, Tas, NT, Australia)
  • remoteness area (Major cities, Inner regional, Outer regional, Remote, Very remote, Australia)
  • organisation type (ACCHO, non-ACCHO, Total).

Reporting periods of either June 2017, December 2017, June 2018, December 2018, June 2019, December 2019, June 2020, December 2020, or June 2021 can be selected.

Data supporting this visualisation are available in Excel supplementary data tables at Data.

References

AIHW (Australian Institute of Health and Welfare) (2020) Aboriginal and Torres Strait Islander Health Performance Framework: kidney disease, Canberra: AIHW.

Kidney Health Australia (2020) Chronic Kidney Disease (CKD) Management in Primary Care (4th edition), Melbourne: Kidney Health Australia.

RACGP (Royal Australian College of General Practitioners) (2020) Management of type 2 diabetes: a handbook for general practice, East Melbourne, Vic: RACGP.