The progression of chronic kidney disease can lead to complete kidney failure, necessitating regular dialysis or a kidney transplant due to toxic waste build-up. Access to these life-saving treatments is becoming more challenging.
Demand for dialysis in Australia is projected to increase by almost 86% by 2032 compared to 2022 levels, straining health-care resources. Patients may experience wait times of two to three years for a kidney transplant.
Early detection and treatment of kidney disease before progression is considered beneficial for both patients and the health system.
Kidney Health Australia's action plan outlines a strategy for achieving this critical goal.
Impact of Chronic Kidney Disease
An estimated one in seven Australian adults show indicators of chronic kidney disease, with most unaware of their condition. The prevalence of risk factors is also high, with approximately three out of four Australian adults possessing at least one risk factor, such as diabetes or high blood pressure.
Chronic kidney disease is linked to an elevated risk of heart attack, stroke, and premature death. It imposes a significant public health burden, costing Australia A$9.9 billion annually.
Kidney Function
Kidneys are two fist-sized organs located at the back of the abdomen, performing essential bodily functions. Their primary role involves filtering waste and excess fluid from the bloodstream to produce urine. They also produce hormones vital for red blood cell production and bone health, and regulate blood pressure by maintaining salt and mineral balance.
Kidney disease can originate and progress due to various factors. For instance, high blood glucose levels and high blood pressure can damage kidney blood vessels and nephrons, impairing the kidneys' filtering capacity.
Silent Progression and Symptoms
Kidney disease is often described as "silent" because kidneys can lose up to 90% of their function before symptoms become apparent. This makes early awareness and screening critically important.
By the time these symptoms develop, kidney damage is often irreversible, underscoring the importance of prevention.
Common symptoms include:
- Fatigue
- Swelling in the legs and ankles
- Persistent high blood pressure
- Shortness of breath
- Needing to urinate more often, especially at night
- Foamy urine
Prevention Strategies
While not all causes are easily preventable, several measures can significantly reduce the risk of kidney disease:
- Controlling blood pressure
- Managing diabetes effectively
- Maintaining a healthy weight
- Eating a healthy diet with minimal salt intake
- Avoiding smoking
- Exercising regularly
- Drinking sufficient water
- Avoiding excessive, long-term use of NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen.
Early Detection Recommendations
Kidney Health Australia proposes that general practitioners conduct a "kidney health check" every one to two years for individuals at higher risk. This targeted screening aims to catch the disease before it progresses to an irreversible stage.
High-risk groups include:
- People with diabetes, high blood pressure, heart disease, or obesity
- First Nations people
- People who smoke or vape (or have done so previously)
- Individuals with a family history of kidney disease
- Those aged over 60
The check is straightforward, involving:
- A blood pressure reading
- A blood test for kidney function
- A urine test to assess protein levels
It is estimated that early detection and treatment could prevent over 38,000 premature deaths, generate 165,000 additional healthy life years, and yield a saving of $45 for every $1 invested over the next two decades.
Many causes of kidney disease, such as high blood pressure and diabetes, are largely preventable. Increased awareness of kidney care, simple screening, and early intervention have the potential to prevent many Australians from progressing to kidney failure.