Chronic kidney disease: Australian facts

The Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry is a clinical quality registry that collects and produces a wide range of statistics on the outcomes of treatment of people with kidney failure. The registry collects information to monitor dialysis and transplant treatments from all kidney units in Australia and New Zealand. It operates under the South Australian Health and Medical Research Institute.

The ANZDATA Registry includes information on the status of treatment with kidney replacement therapy (KRT), including if a person has recovered their kidney function, people who had a transplant overseas, people who were lost to follow-up, and people who had a kidney transplant that failed and who died.

Data on the incidence and prevalence and treatment of kidney failure with KRT presented in this report excluded people who:

• recovered their kidney function
• were lost to follow-up
• died.

This is different from exclusion criteria used for these analyses in previous AIHW reports, which also excluded people who had a kidney transplant overseas and whose graft function failed. These people are now included because, regardless of where they received a transplant or whether their transplant is functioning, they are still receiving follow-up care or KRT in Australia.

Information about the data quality of the ANZDATA Registry can be found in the ANZDATA 45th Annual Report 2023.

The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) is a national survey that was conducted by the International Diabetes Institute (now Baker Heart and Diabetes Institute). It collected national measurements of chronic kidney disease (CKD) biomarkers: serum creatinine and albuminuria for an adult population aged 25 and over (11,700 people). Of the eligible households, 70% responded to the biomedical survey, and 37% of eligible respondents got tested (Dunstan et al. 2002). Standardised creatinine results from the survey participants were supplied by the research team to conduct this analysis on comparable estimated glomerular filtration rate (eGFR) measures.

For more information on AusDiab, see About AusDiab.

In 2011–13, the Australian Heath Survey incorporated the first Australian Bureau of Statistics (ABS) biomedical collection – the National Health Measures Survey. It involved the collection of a range of blood and urine tests from over 11,000 participants across Australia, which were then tested for various chronic disease and nutrient biomarkers.

Urine samples were collected from respondents aged 5 and over, and blood samples from respondents aged 12 and over. 36% of the survey participants volunteered to get the biomedical tests, covering 85% of the sampled households. CKD biomarkers collected were used to derive the eGFR measure from the CKD-epi formula and the albumin:creatinine ratio (ABS 2014, Johnson et al. 2012).

For more information, see:

• Australian Health Survey: biomedical results for chronic diseases
• Australian Health Survey: biomedical results for chronic diseases methodology.

Data quality statement

The data quality statement for the National Health Measures Survey 2011–12 is available on the ABS website: Australian Health Survey: Biomedical Results for Chronic Diseases methodology, 2011-12 financial year. Australian Health Survey: biomedical results for chronic diseases

In 2012–13, the Australian Aboriginal and Torres Strait Islander Health Survey incorporated the first biomedical collection to be undertaken for the First Nations population in an ABS survey – the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS). It involved the collection of a range of blood and urine tests from approximately 3,300 participants aged 18 years and over across Australia.

First results from this collection for biomarkers of chronic disease (such as diabetes, cardiovascular disease and kidney disease) and nutrients (such as vitamin D, iron and iodine) were published by the ABS (ABS 2014).

Further information can be found on the ABS website.

The ABS conducts the National Health Survey (NHS) to obtain national information on the health status of Australians, their use of health services and facilities, and health-related aspects of their lifestyle. The most recent NHS was conducted in 2020–21, which is based on information self-reported by participants.  

Previous versions of the NHS have primarily been administered by trained ABS interviewers and were conducted face-to-face. The 2020–21 NHS was conducted during the COVID-19 pandemic. To maintain the safety of survey respondents and ABS Interviewers, the survey was collected via online, self-completed forms.

Non-response is usually reduced through interviewer follow-up of households who have not responded. As this was not possible during lockdown periods, there were lower response rates than previous NHS cycles, which impacted sample representativeness for some sub-populations.

Additionally, the impact of COVID-19 and lockdowns might also have had direct or indirect impacts on people’s usual behaviour over the 2020–21 period. Therefore, this report uses data from the 2017–18 NHS.

The NHS collects self-reported data on whether a respondent had one or more long‑term health conditions; that is, conditions that lasted, or were expected to last, 6 months or more.

This report uses self-reported data to derive prevalence estimates for risk factors for CKD. It does not use self-reported data for the incidence and prevalence of CKD itself, because estimates based on these data are considered to be unreliable and vastly undercount the number of people with CKD in Australia.

When interpreting data from the 2017–18 NHS, some limitations need to be considered:

• Data that are self-reported rely on respondents knowing and providing accurate information.
• The survey does not include information from people living in nursing homes or otherwise institutionalised.
• Residents of Very remote areas and discrete First Nations communities were excluded from the survey. This is unlikely to affect national estimates but will have an impact on prevalence estimates by remoteness.

For more information, see National Health Survey: first results, 2017–18.

Data quality statement

The data quality statement for the National Health Survey 2017–18 is available on the ABS website: 4363.0 - National Health Survey: Users' Guide, 2017–18.

The ABS conducts the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) to obtain national information on the health of First Nations people, their use of health services and health-related aspects of their lifestyle. The most recent NATSIHS was conducted in 2018–19.

The NATSIHS collects information from First Nations people of all ages in non-remote and remote areas of Australia, including discrete First Nations communities.

For more information, see National Aboriginal and Torres Strait Islander Health Survey, 2018–19.

Data quality statement

The data quality statement for the National Aboriginal and Torres Strait Islander Health Survey is available on the ABS website: National Aboriginal and Torres Strait Islander Health Survey methodology, 2018-19 financial year.

The AIHW National Hospital Morbidity Database (NHMD) is a compilation of episode‑level records from admitted patient morbidity data collection systems in Australian hospitals.

Reporting to the NHMD occurs at the end of a person’s admitted episode of care (separation or hospitalisation) and is based on the clinical documentation for that hospitalisation.

The NHMD is based on the Admitted Patient Care National Minimum Data Set (APC NMDS). It records information on admitted patient care (hospitalisations) in essentially all hospitals in Australia, and includes demographic, administrative and length-of-stay data, as well as data on the diagnoses of patients, the procedures they underwent in hospital and external causes of injury and poisoning.

The hospital separations data do not include episodes of non-admitted patient care given in outpatient clinics or emergency departments. Patients in these settings may be admitted later, with the care provided to them as admitted patients being included in the NHMD.

The following care types were excluded when undertaking the analysis: 7.3 (newborn – unqualified days only), 9 (organ procurement – posthumous) and 10 (hospital boarder).

The National Hospital Morbidity Database include information on people’s area of usual residence at the time of hospitalisation. 

For 2021–22, this was their SA2 based on the 2016 ASGS. In this report, 2016 SA2 values have been concorded to SA2 values based on the 2021 census prior to calculating rates

Further information about the NHMD can be found in Admitted patient care NMDS 2021–22- external site opens in new window- external site opens in new window.

The AIHW National Non-admitted Patient Emergency Department Care Database (NNAPEDCD) is a compilation of episode-level records (including waiting times for care) for non-admitted patients who are registered for care in emergency departments in selected public hospitals. The database captures information only for physical presentations to emergency departments and does not include advice provided via telehealth or videoconferencing.

Patients being treated in emergency departments may be later admitted, including admission in the emergency department, another hospital ward or to hospital‑in-the-home. For this reason, there is an overlap in the scope of the NNAPEDCD, the NMDS and the APC NMDS.

Principal diagnoses for episodes of care in the NNAPEDCD 2019–20 are coded according to the Emergency Department ICD-10-AM Principal Diagnosis Shortlist.

For more information on the NNAPEDCD, see Non-admitted patient emergency department care NMDS 2020–21.

The AIHW National Mortality Database (NMD) comprises information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. The cause of death data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice); they include cause of death coded by the ABS. The data are maintained by the AIHW in the NMD.

In this report, deaths registered in 2019 and earlier are based on the final version of cause of death data; deaths registered in 2020 are based on the revised version; and deaths registered in 2021 and 2022 are based on the preliminary version. Revised and preliminary versions are subject to further revision by the ABS.

For data by Indigenous status, counts of death are reported for 8 jurisdictions combined – New South Wales, Australian Capital Territory, Victoria, Queensland, Western Australia, South Australia, Tasmania and the Northern Territory. Death rates are reported for 5 jurisdictions combined – New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. These jurisdictions are considered to have adequate levels of First Nations identification in mortality data.

This report adjusts for Victorian additional death registrations of deaths that were registered in Victoria in 2017 and 2018 but were not provided to the ABS for compilation until 2019. As a result, the number of diabetes deaths reported for 2017 to 2019 may differ from previously reported numbers. For more detail, see the Technical note: Victorian additional registrations and time series adjustments in Causes of death, Australian methodology- external site opens in new window- external site opens in new window.

The NMD includes information on people’s area of usual residence prior to death. For 2022, this was their SA2 based on the 2021 ASGS. This location information from the National Mortality Database, along with IRSD values based on the ABS 2021 Census of Population and Housing, and estimated resident populations for 2022, have been used to approximate statistics for 2022 ASGS Remoteness Areas and 2022 IRSD SEIFA quintiles.

The data quality statements underpinning the AIHW NMD can be found in the following ABS publications:

• ABS quality declaration summary for Deaths, Australia methodology
• ABS quality declaration summary for Causes of death, Australia methodology.

For more information, see National Mortality Database (NMD).

The Australian Burden of Disease Study (ABDS) undertaken by the AIHW provides information on the burden of disease for the Australian population. Burden of disease analysis measures the impact of fatal (or years of life lost, YLL) and non-fatal burden (years lived with disability, YLD), with the sum of non-fatal and fatal burden equating the total burden (disability-adjusted life year, DALY).

The ABDS 2023 is different to the 2003, 2011, 2015 and 2018 studies in that estimates have been produced for the current year (2023). It builds on work from the ABDS 2022, which was the first study where burden was estimated for the year of release (2022). ABDS 2023 includes disease burden estimates for the year of release (2023) for 220 diseases and injuries, including estimates of burden for COVID‑19. This Study provides burden of disease estimates best matched to the public health context for the Australian population for 2023.

The 2018 study also provides estimates of how much of the burden can be attributed to 20 different risk factors. It also includes a component on the impact and causes of illness and death in First Nations people, which includes estimates of the gap in disease burden between First Nations and non-Indigenous Australians. Estimates of the burden of disease for First Nations people are available for 2003, 2011 and 2018.

For more information, see Burden of disease.

The AIHW Disease Expenditure Database provides a broad picture of the use of health system resources classified by disease groups and conditions.

It contains estimates of expenditure by Australian Burden of Disease Study condition, age group and sex for admitted patient, emergency department, and outpatient hospital services, out-of-hospital medical services and prescription pharmaceuticals.

It does not allocate all expenditure on health goods and services by disease – for example, neither administration expenditure nor capital expenditure can be meaningfully attributed to any particular condition due to their nature.

For more information, see Health system spending on disease and injury in Australia, 2020-21.

In the 2020–21 study compared to previous disease expenditure studies, there were changes to the methods used for MBS mapping, Emergency Department (ED) analysis, Non-admitted patient analysis (NAP) and the identification of COVID-19 cases.  

For further details on the methods used, refer to Health system spending of disease and injury in Australia: Overview of analysis and methodology 2020–21.

References

ABS (2014) Australian Aboriginal and Torres Strait Islander health survey: biomedical results, 2012–13, ABS, Australian Government, accessed 18 March 2022.

Dunstan DW, Zimmet PZ, Welborn TA, Cameron AJ, Adrian J, Shaw J et al. (2002) ‘The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) – methods and response rates’, Diabetes Research and Clinical Practice, 57:119–29, doi: 10.1016/s0168-8227(02)00025-6.

Johnson DW, Jones GRD, Mathew TH, Ludlow MJ, Doogue MP, Jose MD et al. (Australasian Creatinine Consensus Working Group) (2012) Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: new developments and revised recommendations, Medical Journal of Australia, 197(4):222–223, doi: 10.5694/mja11.11329.