End-stage kidney disease (ESKD) is the most severe form of chronic kidney disease, where kidney function deteriorates to the extent that kidney replacement therapy (KRT) in the form of dialysis or kidney transplantation is required to survive. This report estimates the total number of new cases (incidence) of ESKD in Australia, including cases treated with KRT and those not receiving these treatments.
The total incidence of ESKD has been estimated by using data from the Australian and New Zealand Dialysis and Transplant Registry and Australian Institute of Health and Welfare National Mortality Database.
In 2013, the number of new cases of ESKD in Australia was around 5,100, or around 14 cases per day. This equates to an age-adjusted incidence rate of 19 cases per 100,000 population.
A similar number of people with ESKD in 2013 were receiving kidney replacement therapy (KRT-treated) and not receiving these treatments (non-KRT-treated) – around 2,500 each.
While the number of new cases of ESKD (KRT-treated and non-KRT-treated) increased between 1997 and 2013, the ESKD incidence rate for both treatment groups remained relatively stable between 2001 and 2013: an average of 10 cases per 100,000 population per year for both treatment groups over this period.
In 2013, ESKD incidence rates among males were 1.5 times that of females. Overall, this pattern was similar between 1997 and 2013.
The incidence of ESKD increased rapidly with age, with rates highest among those aged 75 and over―almost 4 times the rate as those aged 65–74 in 2013.
In 2009–2013, the incidence rate of ESKD was almost 5 times as high among Indigenous compared with non-Indigenous Australians, with the gap considerably higher for those middle aged―around 12 times as high for those aged 35–64. This reflects the earlier onset of ESKD among Indigenous Australians.
The earlier onset of ESKD among Indigenous Australians compared with non-Indigenous Australians occurs among both treatment groups―on average 10 years earlier for KRT-treated and 18 years earlier for non-KRT-treated.
In 2009–2013, those living in Remote and very remote areas of Australia had higher incidence rates of ESKD, with rates twice as high as those in Major cities.
In 2009–2013, living in an area with socioeconomic disadvantage was also associated with higher ESKD incidence rates, with rates 1.6 times as high in the lowest compared with the highest socioeconomic areas.
In 2009–2013, there were an estimated 25,700 new cases of ESKD in Australia. Of these, around 80% also died within this period. Common causes of death included cardiovascular disease and diabetes.