Chronic disease
Chronic Kidney Disease (CKD) and End-Stage Kidney Disease (ESKD)
Chronic Kidney Disease is a debilitating chronic disease in its own right, but can also contribute to, or be impacted by, other prominent chronic diseases, including cardiovascular disease and diabetes mellitus.
. Work of the Australian Government on CKD and ESKD
Chronic Kidney Disease (CKD) is a debilitating chronic disease in its own right, but can also contribute to, or be impacted by, other prominent chronic diseases, including cardiovascular disease and diabetes mellitus. In some cases, a person affected by CKD will have their condition worsen to a point where End-Stage Kidney Disease (ESKD) develops and the individual requires kidney replacement therapy in order to survive.
In this section:
- Chronic Kidney Disease (CKD) and End-Stage Kidney Disease (ESKD)
- Work of the Australian Government on CKD and ESKD
What are CKD and ESKD?
CKD refers to all conditions of the kidney, lasting at least 3 months, where a person has had evidence of kidney damage and/or reduced kidney function, regardless of the specific diagnosis of disease or condition causing the disease. Evidence of kidney damage manifests as either urinary protein or albumin (a type of protein that is a more sensitive and specific marker of kidney disease), blood in the urine, or scarring detected by imaging tests1.CKD is categorised into 5 stages according to the level of reduced kidney function and evidence of kidney damage. Stages of CKD are measured by the glomerular filtration rate, which is the amount of blood the kidneys clear of waste products in one minute. Because this rate cannot easily be measured directly, current practice is to estimate it by applying a formula based on age, gender and creatinine (a breakdown product of a molecule found in muscle that is important for energy storage) in the blood. An individual can move up and down through the first four stages of severity, but once they reach stage 5, their kidney function does not usually improve2.
In severe cases, kidney function may deteriorate to the extent that it is no longer sufficient to sustain life and, if untreated, will most likely cause death. This is called ESKD and those affected by this disease require kidney replacement therapy - either dialysis or kidney transplant - to survive3.Top of page
How common are CKD and ESKD?
CKD can often lack symptoms in its early stages so the diagnosis of kidney disease is often delayed or missed, which makes it difficult to accurately gauge the number of persons affected by the disease4. Some estimates indicate, however, that as many as 1 in every 7 Australians, aged 25 years and over (more than 2 million persons), have at least one indicator of kidney damage5, 6.CKD closely co-exists with other key chronic diseases - cardiovascular disease and type 2 diabetes - with these three diseases accounting for around a quarter of the entire disease burden in Australia7. Accordingly, CKD shares a number of common risk factors with these other chronic diseases, including: overweight and obesity, physical inactivity, poor diet, tobacco smoking, high blood pressure (hypertension), and low birthweight8. CKD is a disease that may be prevented or delayed and prevention is a primary aim for Government, given the substantial burden of disease involved with CKD, which contributed to nearly 10% of all deaths in 2006 and over 1.1 million hospitalisations in 2006-079.
CKD is a particular problem among Aboriginal and Torres Strait Islander people, with Indigenous persons being 5 times as likely to be hospitalised for the disease, or have it recorded on their death certificate, as non-Indigenous Australians10.
In 2010, 18,971 Australians received kidney replacement therapy (KRT) for ESKD, including 8,382 persons who had a functioning kidney transplant and 10,590 who were receiving dialysis treatment11. Males account for around 54% of all ESKD cases, with more than 70% of deaths where renal failure is the underlying factor occurring among persons aged 70 years and over12.Top of page
Further information
For information on the signs and symptoms of diabetes or advice about diabetes management, please refer to the following websites:1 Australian Institute of Health and Welfare (2009). An overview of chronic kidney disease in Australia 2009, page vi.
2 Australian Institute of Health and Welfare (2011). End-stage kidney disease in Australia: total incidence 2003-2007, page 1.
3 Australian Institute of Health and Welfare (2010). Chronic kidney disease hospitalisations in Australia 2000-01 to 2007-08, page 1.
4 Australian Institute of Health and Welfare (2008). Indicators for chronic diseases and their determinants, 2008, page 13.
5 Atkins RC, et al (2004). Prevalence of albuminuria in Australia: the AusDiab Kidney Study. Kidney International.
6 Chadban SJ, et al (2003). Prevalence of kidney damage in Australian adults: The AusDiab kidney study. Journal of the American Society of Nephrology.
7 Begg S, et al (2007). The burden of disease and injury in Australia 2003. AIHW, page 37.
8 Australian Institute of Health and Welfare (2009). Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors, page 11.
9 ibid, page 3.
10 Australian Institute of Health and Welfare (2010). Australia’s health 2010, page 240.
11 McDonald S, et al (2011). Australia and New Zealand Dialysis and Transplant Registry Report 2011. ANZDATA.
12 Australian Institute of Health and Welfare (2011). End-stage kidney disease in Australia: total incidence 2003-2007, page 39.
