Abstract
ObjectiveTo report (using linked laboratory data) the incidence, prevalence and geographic variation of chronic kidney disease (CKD) across the whole island population of Tasmania, Australia.MethodsA retrospective cohort study (the Tasmanian Chronic Kidney Disease study (CKD.TASlink)) using linked data from five health and two pathology datasets from the island state of Tasmania, Australia between 1/1/2004 and 31/12/2017. We used data on 460,737 Tasmanian adults (aged 18 years and older, representing 86.8% of the state’s population) who had a serum creatinine measured during the study period. We defined CKD as per Kidney Disease Outcomes Quality Initiative, requiring two measures of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2, at least three months apart. Kidney replacement therapy (KRT) included dialysis or kidney transplantation.ResultsWe identified 56,438 Tasmanians with CKD during the study period, equating to an age-standardised annual incidence of 1.0% and a prevalence of 6.5%. These figures were higher in women, older Tasmanians and people living in the North-West region of Tasmania. Testing for urinary albumin:creatinine ratio is increasing, with 28.5% of women and 30.8% of men with stage 3 CKD having both an eGFR and uACR in 2017. Use of KRT was consistently seen in >65% of Tasmanians with eGFR <15 mL/min/1.73m2.ConclusionThere is geographic and gender variation in the incidence and prevalence of CKD, but it is reassuring to see that the majority of people with end-stage kidney failure are actually receiving treatment with dialysis or transplantation.
Highlights
The burden of chronic kidney disease (CKD) in Australia is increasing rapidly [1]
There is geographic and gender variation in the incidence and prevalence of CKD, but it is reassuring to see that the majority of people with end-stage kidney failure are receiving treatment with dialysis or transplantation
Kidney disease is diagnosed by measuring albumin in a urine sample and creatinine in a blood test
Summary
The burden of chronic kidney disease (CKD) in Australia is increasing rapidly [1]. the financial cost of treating all people with kidney failure with dialysis or kidney transplantation is unsustainable and the community cost undesirable [2]. The population of Tasmania, an island state of Australia, has a high burden of chronic disease, including hypertension, obesity, cardiovascular disease and mental health problems [3]. All of these are known risk factors for the development of kidney disease, a progressive condition that once it is well established, it is (currently) not possible to reverse. Kidney disease is diagnosed by measuring albumin in a urine sample (urine albumin:creatinine ratio, uACR) and creatinine in a blood test The latter is used to estimate glomerular filtration rate (eGFR), a measure of kidney function. Use of kidney replacement therapy (dialysis or kidney transplantation) occurs in stage five when appropriate
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