Chronic kidney disease: briefing paper plain language summary

This paper describes key issues that affect the care of people with, or at risk of, chronic kidney disease (CKD) in the community. It also suggests actions that might help these people and the health professionals providing care for them. This paper is to help researchers, kidney health groups, health professionals and government improve their understanding of CKD and what to do about it.

CKD means a person’s kidneys are not working as well as they should and/or show signs of damage for 3 months or more.

CKD is a major health problem in Australia

Approximately 10% of Australian adults have signs that suggest they may have CKD. It is twice as common as diabetes. It is a factor in 11% of all deaths and over one-third of all heart-related deaths. It costs the health system $5.1 billion per year.

It’s a silent disease

Less than one in 10 people with signs of CKD know they may have it. Few people with CKD notice symptoms in the early stages. Many only find out when they have advanced CKD. In advanced CKD much of the kidney function is lost and there are less treatment options.

The impact of CKD is greater for people living in remote or low-income areas

People with CKD living in these communities are more likely to need hospital care. Death from CKD is highest for people living in remote areas.

It affects more Aboriginal and Torres Strait Islander people

Nearly one in five Aboriginal and Torres Strait Islander adults have signs of CKD. They are twice as likely to have CKD than non-Indigenous Australians.

Aboriginal and Torres Strait Islander ethnicity is not a risk factor for CKD and its progression. Rather, many risk factors for CKD among Aboriginal and Torres Strait Islander people are connected to social disadvantage and ongoing impacts of colonisation.

CKD has shared risk factors and links with other health problems

High blood pressure, smoking and being very overweight can raise the chance of CKD and other health problems like diabetes and heart disease. These other health problems are also risk factors for CKD.

CKD needs careful prescribing and monitoring of medicines

People with CKD are often taking many medicines. Some medicines, including those taken at the wrong dose, can cause more damage to the kidneys. This damage can need hospital care or even lead to death.

In 2022 NPS MedicineWise started a program called Chronic kidney disease: early detection and management. Many resources are available for consumers and health professionals here.

The program helps health professionals and people in the community to learn and do more about this problem. The Australian Government Department of Health and Aged Care funds the program.

Research by NPS MedicineWise and others found common factors that affect the care of people with CKD.

What are barriers to better care?

• Low awareness of CKD among health professionals and in the community. Many people do not know they are at risk of CKD or get tested for it.
• Health professionals may not feel confident diagnosing CKD and talking to their patients about the condition.
• Confusion about which CKD guidelines to follow.
• Other health problems, like heart diseases, can be seen as more important.
• Health professionals prescribing medicines, including at the wrong doses, that can cause more kidney damage.
• People living in rural and remote areas often have to travel a very long way to get care.

What can help improve care?

• Improving health professionals’ knowledge about risk factors for CKD.
• People at risk of CKD having their kidney health checked every 1–2 years.
• People with CKD feeling more confident about taking part in their own care. Health professionals can help them understand their kidney test results, treatments and what to expect over time.
• Health professionals and people with CKD working together to make a kidney health plan. This includes helpful non-medicine treatments, like exercise and healthy eating.
• Improving health professionals’ knowledge about prescribing medicines to protect kidney health.

This briefing paper gives examples of other actions to improve care for people with CKD in the community:

• Campaigns to let more people know about CKD, especially people or groups with the highest risk.
• Making it easier for people with CKD in remote and low-income areas to get care, eg, using telehealth.
• Giving health professionals ideas on how to teach people about CKD and how to use medicines safely.

The full version of the briefing paper is available below.