One in 20 hospitalisations in Australia is a person living with diabetes undergoing dialysis, and that figure is projected to rise as rates of kidney failure are expected to increase by 45% by 2040.

A new report, released today by Diabetes Australia, highlights the alarming rise in diabetes-related kidney disease and the massive impact this is having on the Australian health system.

The report estimates diabetes-related kidney disease costs Australia $2.68B per annum with the majority of the cost ($1.9B) associated with people living with diabetes experiencing kidney failure.

It calls for the introduction of a Diabetes Kidney Disease Screening Program to ensure people living with diabetes at high-risk of end-stage kidney disease are detected early when treatments are most effective.

The report also found:

• 324 Australians living with diabetes undergo a kidney transplant each year
• 10,249 Australians living with diabetes are undergoing kidney replacement therapy including dialysis each year
• 2,024 Australians living with diabetes die from kidney disease each year
• Better early detection of kidney disease could save the Australian economy around $500M per annum

Diabetes Australia Group CEO Justine Cain said the report was compelling proof of the need for earlier intervention to help prevent kidney failure.

“There are an estimated 330,000 people living with diabetes-related kidney disease which is about a quarter of all people living with diabetes,” Ms Cain said.

“More than 10,000 Australians living with diabetes are undergoing kidney replacement therapy which can include dialysis or kidney transplantation.

“Most kidney failure can be prevented with early intervention; however, just under a quarter (23%) of people are getting their kidneys checked within recommended timeframes.

“Several factors contribute to this including the complexity of the kidney health checks, the overall challenges of living with diabetes, and a low level of awareness about chronic kidney disease.”

Report co-author Professor Richard MacIsaac, Director of Endocrinology at St Vincent’s Hospital Melbourne, said keeping as many people off dialysis as possible was crucial.

“Dialysis takes a huge toll on the quality of life of the person receiving it and represents a massive burden on our health system,” Professor MacIsaac said.

“A person receiving dialysis is visiting hospital more than 150 times a year to receive around 780 hours of care.

“But if we can detect people early, existing medicines are excellent at stopping or slowing the progression of kidney disease.”

Lead author of the report, Professor Elif Ekinci, Director of the Australian Centre for Accelerating Diabetes Innovation, said the report clearly highlighted the impact of diabetes-related kidney disease and the need for urgent action.

“Diabetes is one of the most urgent health challenges of our time and one of the reasons for this is the massive impact of diabetes-related complications such as kidney disease,” Professor Ekinci said.

“The report sets out some clear recommendations for improving rates of screening for kidney disease and if we can reduce the impact of diabetes-related kidney disease.”

Ms Cain said Australia has a world-class health system, with many of the elements needed to deliver an effective national diabetes kidney disease screening program.

“Australia has excellent diabetes care infrastructure including a world-class diabetes health professional workforce, the National Diabetes Services Scheme which provides excellent information for people living with diabetes, and the Pharmaceutical Benefits Scheme which ensures people can affordably access the medicines they need,” she said.

“Reducing the impact of diabetes-related kidney disease is cost-effective. It doesn’t require new clinics, new operating theatres or new hospital beds.

“It involves taking our existing health infrastructure, including existing databases and services, and optimising them to increase rates of screening.

“For instance, we are proposing that the NDSS database, managed by Diabetes Australia on behalf of the Australian Government, could be optimised to facilitate recall and reminders to encourage kidney checks for all Australians living with diabetes.

“Better integration with existing GP and pathology software could also support better information sharing between different members of a person’s healthcare team.

“Finally, this screening can be done with existing Medicare item numbers using existing pathology providers and primary care services.

“This is one of the most cost-effective interventions we can implement across the entire health system. Modelling shows every dollar spent on the detection and prevention of chronic kidney disease returns around $45.

“If we get this right we save lives and can reduce the impact of diabetes complications on our health system.”

Diabetes Australia commissioned the Australian Centre for Accelerating Diabetes Innovation led by Professor Elif Ekinci, Sir Edward Weary Dunlop Principal Research Fellow in Metabolic Medicine, and Dame Kate Campbell, Fellow at the University of Melbourne. Professor Ekinci is the lead author of the report.

A copy of the report is available here: Change the Future: Saving Lives by Better Detecting Diabetes-Related Kidney Disease