Kidney Health Australia calls for proactive testing of Australians at high risk of kidney disease

To mark World Kidney Health Day, Kidney Health Australia (KHA) has launched a report detailing the links between chronic kidney disease, diabetes, cardiovascular disease, and mental health. The findings reveal the urgent need for healthcare providers to consider these links when treating their patients.

The report, funded through an unrestricted grant from Boehringer Ingelheim and Eli Lilly, ‘Make the Link – Kidneys, Diabetes and Heart’ has been released ahead of Kidney Health Australia’s Kidney Health Week. The awareness week will run from Monday 15^th to Friday 21^st March 2021. The focus this year is on the importance of early detection of kidney disease and urging people to check their risk factors and if at risk to seek a Kidney Health Check from their GP.

CKD, diabetes and cardiovascular disease are inherently linked by common risk factors and connecting pathways in the body. According to the extensive report, an estimated 29% of Australian adults have one or more of these conditions.

The research revealed, in people with existing cardiovascular disease, the presence of CKD increases the risks of death and hospitalisation. Cardiovascular mortality is approximately 60% higher in people with CKD compared to those without CKD. Concerningly, the report also revealed an increase in incidences of kidney failure in the younger type 2 diabetes population.

According to the report’s findings, an additional diagnosis of CKD increased the average length of hospital stays by four days for people diagnosed with cardiovascular disease, and by two days for people diagnosed with diabetes.

Kidney Health Australia’s Evidence Report has revealed that CKD is under-diagnosed in primary practice, including in people with diabetes and hypertension. A long-term, coordinated approach to the detection and prevention of CKD, diabetes and cardiovascular disease is crucial.

Associate Professor Shilpa Jesudason, Nephrologist, who was involved in the development of the Evidence Report said, “Prevention is the key to reducing the number of people affected by CKD in Australia and the only way to do that is by proactively testing for it.

“If you’re treating someone with cardiovascular disease then you need to be thinking about the kidneys too. New and existing treatments are highly effective but under-utilised. CKD is a silent killer and carries little to no symptoms until it is sometimes too late. It’s important that healthcare providers are recognising this, specifically the link between comorbid diseases to proactively identify and test their patients.”

The report revealed how the burden of CKD is unevenly distributed across the Australian population. Amongst Aboriginal and Torres Strait Islander adults with diabetes, 56% have comorbid CKD, compared to 32% of non-Indigenous Australians. Among Aboriginal and Torres Strait Islander adults with cardiovascular disease, 32% have comorbid CKD (compared to 21% of non-Indigenous Australians).

Furthermore, the Evidence Report revealed the presence of any one of CKD, diabetes or cardiovascular disease increases the likelihood of having depression and is associated with reduced quality of life. Depression has also been found to extend to the partner of a person who has kidney failure. The presence of depression increases the risk of new onset diabetes and cardiovascular disease. Depression is also a risk marker for worse outcomes of both conditions, including greater likelihood of developing CKD.

General practitioner Professor Tim Usherwood said “This report shows the vital role General Practitioners must play in identifying patients with early stages of chronic kidney disease, particularly those who are more vulnerable in our society, with less access to healthcare due to geographical location or for other reasons. It is especially important for healthcare providers to consider the possibility that chronic kidney disease could be affecting their patients with diabetes and cardiovascular disease.

“The statistics are concerning and we need to take action to reduce the impact of a disease that can be preventable when detected early enough.

“For those who are already living with advanced kidney disease, it is important for healthcare providers to consider the effects a diagnosis of that enormity will be having on the people closest to that person.”

The cumulative cost of treating all current and new cases of kidney failure with dialysis or kidney transplantation from 2009 to 2020 is estimated to be between $11.3 billion and $12.3 billion. This further highlights the urgent need for screening and early detection in primary care.