Large increase in treated end-stage kidney disease

The number of Australians treated with dialysis or kidney transplantation for their end-stage kidney disease (ESKD) almost tripled between 1991 and 2009, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

ESKD is the most severe form of chronic kidney disease, where kidney function is so reduced that dialysis or a transplant is necessary for survival.

The report, Dialysis and kidney transplantation in Australia, states that the reasons for the increase in cases of treated ESKD are complex, and an increase in diabetes-related cases of ESKD is likely to play a large part. The report largely draws on data from the Australian and New Zealand Dialysis and Transplant (ANZDATA) registry.

‘Diabetes-related kidney damage was the leading cause of treated ESKD in 2009, accounting for 33% of new cases compared with 13% in 1991,’ said AIHW spokesperson Dr Lynelle Moon.

Another factor is progressively greater numbers of older people are being treated for ESKD—the average age of people starting kidney replacement therapy (KRT) has risen from 44 years in 1991 to 61 years in 2009.

‘Better survival for patients on KRT is a possible contributor,’ said Dr Moon.

As rates of ESKD have increased, so too have the number of kidney transplantations performed.

From 1991 to 2009, the number of transplants performed each year increased from 470 to 772, largely due to a rise in donations from living donors.

However, this rise in transplant numbers has not been able to keep up with the increasing number of ESKD patients. From 1991 to 2009, the proportion of treated ESKD patients with a functioning transplant decreased from 53% to 43%.

Compared to those from urban areas, treated ESKD patients in remote areas are less likely to have a functioning kidney transplant.

The number of people receiving dialysis has tripled—from 3,138 people in 1991 to 10,432 in 2009. Over this period there has also been a change in where ESKD patients are receiving dialysis, with less patients dialysing at home in 2009 compared to 1991.

The increase in the number of dialysis patients has resulted in an average increase of nearly 60,000 hospitalisations for dialysis every year from 2000–01 to 2009–10.

Dialysis treatment was the number one reason for hospitalisation in 2009-10, making up over 1.1 million hospitalisations, or 13% of the total hospitalisations for this period.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia's health and welfare.


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