Renal disease

Definitions

Chronic kidney disease refers to all conditions of the kidney, lasting at least 3 months, where a person has had evidence of kidney damage and/or reduced kidney function, regardless of the specific diagnosis of disease or condition causing the disease. 

In situations where an individual’s kidney condition deteriorates to the point where existing function cannot sustain life, they will require kidney replacement therapy, which involves either renal dialysis or kidney transplantation. Dialysis is a medical procedure for the filtering and removal of waste products from the bloodstream. Dialysis can be conducted at home, in the hospital or in a satellite clinic. A person on dialysis may recieve several treatments per week. 

Two main types of dialysis are:

• haemodialysis – blood flows out of the body into a machine that filters out the waste products and returns the cleansed blood back into the body.

• peritoneal dialysis – fluid is introduced into the peritoneal cavity via a permanent tube in the abdominal wall. Waste products are filtered through the peritoneum, the thin membrane that surrounds the abdominal organs, from the blood vessels into the fluid, which is drained out periodically.

Kidney and urinary diseases accounted for 1.4% of Australia's total burden of disease in 2015. One in 10 Australian adults had biomedical signs of chronic kidney disease in 2011-12. One in nine deaths in 2017 across Australia had chronic kidney disease as an underlying and/or associated cause of death.

Chronic kidney disease closely co-exists with cardiovascular disease and type 2 diabetes, with these three diseases accounting for around a quarter of the entire disease burden in Australia. Accordingly, chronic kidney disease shares a number of common risk factors with these other chronic diseases, including: overweight and obesity, physical inactivity, poor diet, tobacco smoking, high blood pressure (hypertension), and low birth weight.

Major risk factors associated with chronic kidney disease that cannot be modified include advancing age, genetic predisposition, previous kidney disease or injury, low birth weight, male gender, and family history.

Interventions

As chronic kidney disease shares many modifiable risk factors with other lifestyle-related chronic diseases such as circulatory diseases and type 2 diabetes, strategies related to the prevention, early detection and optimal management of these risk factors (eg smoking, physical inactivity, poor diet, harmful alcohol consumption and being overweight) will lead to better health outcomes for people with lifestyle-related chronic diseases such as chronic kidney disease.  

Australian Department of Health. Chronic conditions: https://www.health.gov.au/health-topics/chronic-conditions

Australian Institute of Health and Welfare. Chronic Kidney Disease: https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-kidney-disease/overview