Kidney disease soars in Australia

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Kidney disease soars in Australia

By Simon Lauder

Posted 1 hour 50 minutes ago

There is new evidence that dialysis is not always effective.

    * Audio: Kidney disease on the rise (The World Today)
    * Related Story: Silent killer on the rise: doctors
    * Related Story: Indigenous patients forced to move for dialysis treatment
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    * Related Story: Health group warns of a 'renal tsunami'

The number of Australians admitted to hospital for kidney dialysis has jumped by more than 70 per cent in the past decade.

A report by the Institute of Health and Welfare says that number is expected to keep growing as Australia's population ages.

But a separate study suggests that for some, dialysis should be delayed.

The Australian Institute of Health and Welfare has, for the first time, examined hospital data on the treatment of chronic kidney disease.

It found that between 2001 and 2008, the number of hospitalisations for regular dialysis in Australia increased by 71 per cent - an extra 60,000 admissions per year.

Researcher Francis Green says that trend is set to continue as Australians get older and fatter.

"Two of the main risk factors for chronic disease - increased age and type 2 diabetes - are increasing in the community so that sort of indicates that this disease is going to keep increasing," he said.

The medical director of Kidney Health Australia, Dr Tim Mathew, says the report paints a distressing picture.

"This is by far the biggest growth area for admissions to hospitals," he said.

"We're now spending $1 billion a year on the direct costs of dialysis programs in Australia."

Dr Mathew says he was not surprised that the increase was as much as 71 per cent.

"What is disappointing is that there is a fairly constant growth over the last 10 years or so going up at about 6 per cent a year, and that's not showing any real sign of decreasing," he said.

In 2008, chronic kidney disease was a contributing factor in 15 per cent of all hospitalisations in Australia and regular dialysis accounted for 4 per cent of all bed days.

Renal physician Dr Pauline Branley says there is an emerging trend to put patients on dialysis early to try to prevent heart problems.

But there is new evidence that dialysis is not always effective.

The results of an eight-year trial involving more than 800 kidney patients in Australia and New Zealand have just been published in the New England Journal of Medicine.

Dr Branley says she wanted to find out if beginning dialysis treatment early has any benefits.

"It showed that patients closely supervised, in which dialysis was delayed for about six months, did just as well as those in whom we started it earlier," she said.

"I think this has a lot of implications in terms of health funding and also in terms of patients' quality of life."

Dr Mathew says the study will give doctors the confidence to wait until symptoms of chronic kidney disease appear before starting dialysis.

Prevention is key

But the key to reducing the burden on the health system is to prevent the condition.

Dr Mathew says Australia has no plan of attack to stop people ending up on dialysis.

"We believe that if we were able to identify a kidney disease early and do the right things with it - which is basically pretty simple medicine like blood pressure control, sugar control, cholesterol control - then we could slow down the rate of progression of people with kidney trouble and ultimately reduce the number of people coming onto dialysis programs," he said.

"There is no program that's targeting kidney disease like there is with diabetes - none of that is happening in the kidney world."

Dr Branley agrees the greatest need is in monitoring and prevention.

"I would anticipate that our dialysis numbers will continue to soar - terrible in terms of patients' quality of life, terrible in terms of the health budget, and essentially we need to be tackling lifestyle issues and really diabetes," she said.

The Institute of Health and Welfare found Indigenous Australians are 11 times more likely to need kidney dialysis than other Australians.

http://www.abc.net.au/news/stories/2010/08/18/2986720.htm?utm_source=twitterfeed&utm_medium=twitter