While chronic kidney disease is often detected too late to be reversible, it can be prevented by a healthy lifestyle, or treated if detected early.
Between July 2017 and June 2019, care involving dialysis was the leading cause of hospitalisation among Indigenous Australians, accounting for 44% (474,745) of all hospitalisations. Excluding dialysis, there were 6,710 hospitalisations for Indigenous Australians due to chronic kidney disease.
Patients with kidney failure, also known as end-stage kidney disease, require either a kidney transplant or dialysis to maintain the functions normally performed by the kidneys. These treatments are collectively known as ‘kidney replacement therapy’.
In the three-year period 2015–2017, 950 Indigenous Australians began kidney replacement therapy for kidney failure, an incidence rate of 64 per 100,000 (age-standardised). In comparison, the age-standardised incidence rate of kidney failure with replacement therapy for non-Indigenous Australians was 9.2 per 100,000.
Between 2008 and 2017, the age-standardised incidence rate for kidney failure with replacement therapy did not change significantly for Indigenous or non-Indigenous Australians (Figure 4.20).
Figure 4.20: Incidence of kidney failure with replacement therapy 2008–2017, and by remoteness area (2015–2017) (age-standardised rates)
As at 31 December 2017, 2,156 Indigenous Australians with kidney failure were receiving kidney replacement therapy. Most Indigenous patients with kidney failure (87% or 1,884) received dialysis, while 13% had received a kidney transplant. In comparison, about half (51%) of non-Indigenous patients received a kidney transplant.
In the 5-year period 2015–2019, 279 deaths of Indigenous Australians were due to kidney disease, based on underlying cause of death. Kidney diseases were the 10th leading cause of death of Indigenous Australians (1.8% of deaths of Indigenous Australians). Indigenous females accounted for 58% of deaths due to kidney disease among Indigenous Australians.
Over the decade between 2010 and 2019, the age-standardised death rate from kidney disease among Indigenous Australians decreased by 36%. However, there was no significant reduction in the gap between Indigenous and non-Indigenous Australians over this period (data from NSW, Qld, WA, SA and NT combined) (Figure 4.21).
Over the decade from 2009–10 to 2018–19, the age-standardised hospitalisation rate for a principal diagnosis of chronic kidney disease increased by 6% for Indigenous Australians. This trend was driven by the increases for Indigenous females (22%) as the rate among Indigenous males declined (16%) (Figure 4.21).
Kidney disease is more likely to be recorded as an additional diagnosis on hospitalisation administrative record or recorded on death certificates as an associated cause compared with other diseases. The above estimations of the impact of kidney disease were based on the principal diagnosis of hospitalisation or underlying cause of death; therefore, will likely underestimate the true extent of chronic kidney disease among Indigenous Australians.
Figure 4.21: Rates of hospitalisations (2009–10 to 2018–19) and deaths (2010–2019) due to kidney disease, by Indigenous status and sex (age-standardised)
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