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All chronic kidney disease

There were almost 1.7 million hospitalisations where chronic kidney disease was recorded as the principal and/or additional diagnosis in 2014–15, according to the AIHW National Hospital Morbidity Database. This represents 17% of all hospitalisations in Australia. Dialysis accounted for the vast majority (80%) of these hospitalisations. Note that hospitalisation data presented here are based on admitted patient episodes of care, including multiple events experienced by the same individual.

In 2014–15 there were around:

  • 42,100 hospitalisations with CKD (excluding dialysis) as the principal diagnosis (the diagnosis largely responsible for hospitalisation)
  • 287,000 hospitalisations with CKD (excluding dialysis) as an additional diagnosis (a coexisting condition with the principal diagnosis or a condition arising during hospitalisation that affects patient management).
  • 1.4 million hospitalisations for regular dialysis as the principal diagnosis only (13% of all hospitalisations in Australia).

Trends for CKD as the principal diagnosis (excluding regular dialysis)

The number of hospitalisations for CKD as the principal diagnosis (excluding regular dialysis) increased by 46% between 2005–06 and 2014–15, from 28,800 to 42,100 hospitalisations. Over this same period, the age-standardised rate increased by 22% (138 and 169 per 100,000 population, respectively) (Figure 1).

Figure 1: Trends in CKD hospitalisations as the principal diagnosis (excluding dialysis), by sex, 2005–06 to 2014–15

The line chart shows that between 2005–06 and 2014–15, the number of hospitalisations per 100,000 population increased from 138 to 171 hospitalisations per 100,000 people for males and 142 to 171 hospitalisations per 100,000 people for females. Rates were very similar for males and females over this period.  

Notes  

  1. Age-standardised to the 2001 Australian Standard Population.
  2. The drop in the male rate in 2010–11 was due to a change in the coding of diabetes in hospital data (see data table for more details).

Source: AIHW National Hospital Morbidity Database (Data table).

CKD hospitalisations as the principal and/or additional diagnosis

When CKD coexists with a different principal diagnosis but affects patient care during hospitalisation, it is recorded as an additional diagnosis. Excluding regular dialysis, CKD is more often coded as an additional diagnosis.

Where CKD was listed as an additional diagnosis, the leading principal diagnoses in 2014–15 were:

  • diseases of the circulatory system (19%)
  • diseases of the respiratory system (9%)
  • diseases of the genitourinary system (9%).

Age and sex

In 2014–15, CKD hospitalisation rates (as the principal and/or additional diagnosis):

  • Were overall similar for males and females (171 per 100,000 population for both). From age 45, age-specific rates were higher for males than females. (Figure 2).
  • Increased with age, with the majority (70%) occurring in those aged 65 and over. CKD hospitalisation rates for males and females were highest in those aged 85 and over (19,506 and 10,727 per 100,000)—at least 1.6 times as high as those in the 75–84 age group (11,171 and 6,724 per 100,000) (Figure 2).

Figure 2: CKD hospitalisations (principal and/or additional diagnosis), by age and sex, 2014–15

The vertical bar chart shows that hospitalisation rates for CKD as a principal and/or additional diagnosis increased steadily with age for both males and females—rates were the highest in those aged 85 and over (19,506 and 10,727 per 100,000 males and females, respectively), at least 1.6 times as high as rate in the 75–84 age group (11,171 and 6,724 per 100,000 males and females).  

Source: AIHW National Hospital Morbidity Database (Data table).

Inequalities

In 2013–14, CKD hospitalisation rates (as the principal and/or additional diagnosis, excluding regular dialysis) increased with remoteness and socioeconomic disadvantage:

  • 2.2 times as high in Remote and very remote areas compared with Major Cities. The gap in these rates was much larger for females than males—3 times as high for females (2,951 compared with 900 per 100,000 population) and 1.5 times as high for males (2,080 compared with 1,421 per 100,000) (Figure 3).
  • 1.9 times as high in the lowest socioeconomic group compared with the highest socioeconomic group (based on area of usual residence)—2.1 times as high for females (1,327 compared with 631 per 100,000) and 1.7 times as high for males (1,781 compared with 1,048 per 100,000) (Figure 3).

Figure 3: CKD hospitalisations (principal and/or additional diagnosis), by remoteness and socioeconomic group, 2013–14

The horizontal bar chart shows that in 2013–14, CKD hospitalisation rates in Remote/Very remote areas were 3 times as high for females & 1.5 times as high for males when compared to Major cities (2,951 & 900 per 100,000 for females & 2,080 & 1,421 per 100,000 for males. Similarly, rates in the lowest socioeconomic group (group 1) compared to the highest socioeconomic group (group 5) were 2.1 times as high for females (1,327 & 631 per 100,000) & 1.7 times as high for males (1,781 & 1,048 per 100,000).

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data table).

Aboriginal and Torres Strait Islander people

In 2013–14, there were around 19,800 hospitalisations for CKD (as the principal and/or additional diagnosis) among Aboriginal and Torres Strait Islander people, a rate of 5,192 per 100,000 population.

  • The rate among Indigenous Australians was overall 5 times as high as the non-Indigenous rate (5,192 compared with 1,067 per 100,000 population).
  • The disparity in CKD hospitalisation rates between Indigenous Australians and non-Indigenous Australians was greater for females than males—6 times as high for females (5,568 compared with 862 per 100,000) and 4 times as high for males (4,770 compared with 1,325 per 100,000).

Regular dialysis

Dialysis is the most common reason for hospitalisation in Australia, accounting for 1.4 million hospitalisations for CKD as the principal diagnosis (13% of all hospitalisations) in 2014–15. Hospitalisations data count the number of dialysis episodes rather than the number of people who receive dialysis. On average, dialysis patients attend 3 sessions per week. For information on how many people receive dialysis, see Australia and New Zealand Dialysis and Transplant Registry (ANZDATA).

Trends

The number of hospitalisations for regular dialysis increased by 53% between 2005–06 and 2014–15, from 884,000 to 1.4 million hospitalisations. In addition, the age-standardised rate increased by 23%, from 4,211 to 5,191 per 100,000 population (Figure 4).

The rate of hospitalisations for regular dialysis among males was consistently higher than that for females over the period, with both showing similar trends and rates of increase.

Figure 4: Trends in regular dialysis hospitalisations (principal diagnosis), 2005–06 to 2014–15

The line chart shows that between 2005–06 and 2014–15, the number of regular dialysis hospitalisations (as a principal diagnosis) per 100,000 population increased from 5,265 to 6,429 hospitalisations per 100,000 people for males and 3,310 to 4,111 hospitalisations per 100,000 people for females. Rates have been consistently higher for males than females over this period.

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data table).

Age and sex

In 2014–15, CKD hospitalisation rates for regular dialysis (as the principal diagnosis):

  • Were overall 1.6 times as high among males than females. Age-specific rates for males were higher than females across all age groups (Figure 5).
  • Increased with age up to age 85, with three-in-four (75%) hospitalisations occurring in those aged 55 and over. CKD hospitalisation rates for regular dialysis for males and females were highest in those aged 75–84 years (41,428 and 21,690 per 100,000 population) (Figure 5).

Figure 5: Regular dialysis hospitalisations (principal diagnosis), by age and sex, 2014–15

The vertical bar chart shows that in 2014–15, regular dialysis hospitalisations (as a principal diagnosis) increased with age for both males and females up to age 84. Rates were highest in those aged 75–84 years for both males and females (41,428 and 21,690 per 100,000 population, respectively). Males had consistently higher rates than females across all age groups.

Source: AIHW National Hospital Morbidity Database (Data table).

Inequalities

In 2013–14, CKD hospitalisation rates for regular dialysis (as the principal diagnosis) increased with remoteness and socioeconomic disadvantage:

  • 2.8 times as high in Remote and very remote areas compared with Major cities. The gap in these rates was much larger for females than males—5 times as high for females (20,567 compared with 3,839 per 100,000 population) and 1.5 times as high for males (10,166 compared with 6,682 per 100,000) (Figure 6). 
  • 2.1 times as high in the lowest socioeconomic group compared with the highest socioeconomic group (based on area of usual residence)—2.6 times as high for females (6,438 compared with 2,505 per 100,000) and 1.7 times as high for males (8,723 compared with 5,008 per 100,000) (Figure 6).

Figure 6: Regular dialysis hospitalisations (principal diagnosis), by remoteness and socioeconomic group, 2013–14

The horizontal bar chart shows that in 2013–14, CKD hospitalisation rates for regular dialysis (as a principal diagnosis) in Remote/Very remote areas compared with Major cities were 5 times as high for females and 1.5 times as high for males. CKD hospitalisation rates for the lowest socioeconomic group (group 1) compared to the highest socioeconomic group (group 5) were 2.6 times as high for females and 1.7 times as high for males. Males had consistently higher rates than females.

Note: Age-standardised to the 2001 Australian Standard Population.

Source: AIHW National Hospital Morbidity Database (Data table).

Aboriginal and Torres Strait Islander people

In 2013–14, there were 186,000 hospitalisations for regular dialysis (as the principal diagnosis) among Aboriginal and Torres Strait Islander people, a rate of 45,084 per 100,000 population.

  • The rate among Indigenous Australians was overall 10 times as high as the non-Indigenous rate (45,084 and 4,389 per 100,000 population).
  • The disparity between Indigenous Australians and non-Indigenous Australians was greater for females than males—16 times as high for females (50,854 compared with 3,259 per 100,000) and 7 times as high for males (39,049 compared with 5,682 per 100,000).

For more information, see Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: morbidity—hospital care and Cardiovascular disease, diabetes and chronic kidney disease: Australian facts—Indigenous Australians.