Chronic kidney disease: Australian facts

Chronic kidney disease (CKD) refers to all conditions of the kidney affecting the filtration and removal of waste from the blood for 3 months or more. It is identified by reduced filtration by the kidney and/or by the leakage of protein or albumin from the blood into the urine.

CKD is mostly diagnosed at more advanced stages when symptoms become more apparent. Kidney failure occurs when the kidneys can no longer function adequately, at which point people require kidney replacement therapy (KRT) – a kidney transplant or dialysis – to survive.

How common is chronic kidney disease?

In 2011–12:

• an estimated 11% of people (1.7 million Australians) aged 18 and over had biomedical signs of CKD, according to Australian Institute of Health and Welfare (AIHW) analysis of the Australian Bureau of Statistics (ABS) latest National Health Measures Survey (NHMS) (ABS 2013)
• the prevalence of CKD increased rapidly with age, affecting around 44% of people aged 75 and over (AIHW 2018)
• only 6.1 of NHMS respondents who showed biomedical signs of CKD self-reported having the disease, indicating that CKD is a largely under-diagnosed condition (ABS 2013).

For more information on the incidence and prevalence of CKD, see How many people are living with chronic kidney disease in Australia?

Change over time

Two national surveys have been conducted in Australia that provide data on biomarkers of CKD – the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) and the 2011–12 NHMS.

Between 1999–2000 and 2011–12:

• the age-standardised CKD prevalence rate remained stable
• the number of Australians with moderate to severe loss of kidney function nearly doubled, from 322,000 to 604,000.

This increase was mostly driven by growth in the population of older people (as people live longer) and by survival of people with kidney failure who are receiving KRT (AIHW 2018).

For more information, see Trends over time.

Kidney failure

Not everyone with kidney failure chooses to receive KRT, opting instead for end-of-life care. Therefore, prevalence estimates for kidney failure need to count cases both with and without replacement therapy. The most recent data available to examine this are linked data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and the National Death Index, covering the period 1997 to 2013 (AIHW 2016).

In 2013:

• there were around 5,100 new cases of kidney failure in Australia – around 14 new cases per day – of these, half (50%) were receiving KRT
• 92% of people with newly diagnosed kidney failure who were aged under 55 received KRT, compared with 19% of people newly diagnosed aged 75 and over.

Before age 75, most new cases of kidney failure are treated with KRT; however, this trend reverses after age 75, with an 11-fold increase in kidney failure without KRT compared with those aged 65–74 (145 and 13 per 100,000 population) (Figure 1) (AIHW 2016).

Figure 1: Incidence of kidney failure with and without replacement therapy, by age, 2013

Impact of chronic kidney disease

Burden of chronic kidney disease

Burden of disease refers to the quantified impact of living with and dying prematurely from a disease or injury.

In 2023, CKD was:

• responsible for 1.1% of the total burden (fatal and non-fatal), compared with 0.8% in 2003
• the 14th leading cause of fatal burden across all age groups
• the sixth leading cause of fatal burden for women aged 85–89 and ninth leading cause of fatal burden for men aged 85–89 (AIHW 2023).

For more information on the burden of CKD, see Burden of chronic kidney disease.

Deaths from chronic kidney disease

CKD contributed to around 22,000 deaths in 2022 (11% of all deaths in Australia), a rate of 84 per 100,000 population. CKD was recorded as the underlying cause of death in 22% and associated cause of death in 78% of CKD deaths. The number of CKD-related deaths has more than doubled since 2000 (when there were 10,200 deaths). 

CKD mortality rates increased slightly year-on-year in both 2021 and 2022 (4.2% and 6.2%, respectively), after adjusting for age (Figure 2). These increases should be interpreted in the context of higher overall mortality in 2022, with two-thirds of excess deaths being associated with COVID-19 (ABS 2023b). People with pre-existing chronic conditions are also at higher risk of more severe outcomes from COVID-19 with chronic kidney diseases being a pre-existing condition among 13.2% of people who died from the virus (registered to 28 February 2023) (ABS 2023a).

For more information on deaths from CKD, see Mortality.

Figure 2: Trends in chronic kidney disease death rates (underlying or associated cause), by sex, 2000 to 2022

Treatment and management of chronic kidney disease

Hospitalisations

CKD was recorded as the principal or additional diagnosis for around 2 million hospitalisations – 18% of all hospitalisations in Australia in 2021–22.

Dialysis was the most common reason for hospitalisation, accounting for 14% of all hospitalisations, and 81% of CKD hospitalisations (1.7 million).

There were 385,000 hospitalisations with a diagnosis of CKD (excluding dialysis as a principal diagnosis). Of these, 85% had CKD as an additional (rather than principal) diagnosis.

Between 2000–01 and 2021–22:

• the number of hospitalisations with CKD as the principal diagnosis (excluding dialysis) more than doubled, from 24,200 to 56,800
• the age-standardised hospitalisation rate for CKD as a principal diagnosis rose by 57%.

For more information, see Hospitalisations for chronic kidney disease.

Kidney replacement therapy

In 2022, around 29,000 people received KRT with 53% being treated with dialysis while 47% were living with a functioning kidney transplant.

The number of people receiving KRT has more than doubled since 2003, from around 13,800 to 29,000 (ANZDATA, 2023).

For more information on kidney replacement therapy, see Treatment of kidney failure.

Population groups

The impact of CKD varies between population groups.

Generally, the impact of CKD in terms of prevalence, hospitalisation, mortality and burden of disease, is greater among Aboriginal and Torres Strait Islander (First Nations) people, people living in lower socioeconomic areas, and people living in Remote and very remote areas. For example:

• An estimated 59,600 First Nations adults (18%) had biomedical signs of CKD in 2012–13 (ABS 2014). First Nations adults were 2.1 times as likely as non-Indigenous adults to have biomedical signs of CKD, after adjusting for age.
• CKD accounted for 2.5% of total disease burden among First Nations people in 2018 (6,500 DALY). The proportion attributed to fatal burden (73%) was higher than non-fatal burden (27%). The burden from CKD was 7.8 times as high among First Nations people as non-Indigenous people (AIHW 2021, 2022).
• Among people living in the lowest socioeconomic areas, there were around 16,200 deaths where CKD was the underlying or associated cause in 2020–2022 (105 per 100,000 population). The CKD death rate among this group was 1.8 times as high as for people living in the highest socioeconomic areas, after adjusting for age.
• Among people living in Remote and very remote areas, there were 17,100 CKD hospitalisations in 2021–22 (3,400 per 100,000 population). People living in these areas were 3.0 times as likely to be hospitalised for CKD as people living in Major cities, after adjusting for age.

Where do I go for more information?

For more information, see Chronic kidney disease: Australian facts.