According to a report released today by the Australian Institute of Health and Welfare (AIHW), with the rise of type II diabetes patients, there is increasing number of hospitalizations related to chronic kidney disease in Australia.
Chronic kidney disease contributed to almost 1.2 million hospitalizations in Australia in 2007-08, one million of which were for regular dialysis, the government group in Canberra said. According to Frances Green, of the Institute’s Cardiovascular, Diabetes and Kidney Unit, “This was about 15 percent of all hospitalizations for that year, with dialysis treatment the most common reason for hospitalization in Australia.” Number of hospitalizations for regular dialysis increased by about 70 percent from 2000-01 to 2007-08. This means almost 60,000 hospitalizations per year. Green said, “A common cause of CKD is diabetes, and it is likely that the increasing prevalence of type 2 diabetes, as well as the ageing population, will result in further increases in CKD hospitalizations over time.” The report also shows that men were 1.6 times as likely as women to be hospitalized for regular dialysis, while indigenous Australians were hospitalized at 11 times the rate of their non- indigenous counterparts.
The medical director of Kidney Health Australia, Dr Tim Mathew warned that, “This is by far the biggest growth area for admissions to hospitals…We're now spending $1 billion a year on the direct costs of dialysis programs in Australia.” “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 added.
In another study there has been doubts whether dialysis should be delayed. Renal physician Dr Pauline Branley feels there is an emerging trend to put patients on dialysis early to try to prevent heart problems. But she explained, this may not always be fruitful. In a large trial that spanned over eight years and involved more than 800 kidney patients in Australia and New Zealand published in the New England Journal of Medicine these concerns were raised. Dr. Branley said, “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…I think this has a lot of implications in terms of health funding and also in terms of patients' quality of life.” Dr Mathew added that this study would give doctors the confidence to wait until symptoms of chronic kidney disease appear before starting dialysis.
However all doctors and experts emphasize that prevention of kidney disease is the key. “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…There is no program that's targeting kidney disease like there is with diabetes - none of that is happening in the kidney world,” Dr. Mathew said.
Dr. Branley echoed these thoughts saying, “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.”
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