Millions of Australians have kidney disease and don’t know it

Two and a half million Australians are unknowingly living with the early stages of kidney disease, a situation that threatens to overrun the nation’s health system in coming years.

The Australian Bureau of Statistics’ National Health Measures Survey says one in 20 people aged 18 to 29, and almost half of those over 75, have early signs of chronic kidney disease.

The looming crisis can be avoided, according to Kidney Health Australia, which is leading a push for a $10 million national targeted testing program and the expansion of new preventative treatments.

A new class of drugs, known as sodium-glucose cotransporter-2 (SGLT2) inhibitors, can slow the progression of chronic kidney disease by more than a decade – provided people know they have the condition.

But because people can lose 90 per cent of kidney function before they show signs of disease, Kidney Health Australia CEO Chris Forbes said most people did not find out they had the condition until it was too late.

“It progresses silently, and hence they call it a silent killer, and then people just crash into kidney failure,” Forbes said.

“That’s when their choices are either gruelling dialysis, the need for a transplant, or, unfortunately, so many more die of a kidney-related heart attack or stroke before they even get the kidney failure.”

The number of Australians being treated for kidney failure, including dialysis, has doubled over the past two decades to 2.7 million, and projections indicate demand will surge by another 42 per cent by 2030.

To reduce the personal and healthcare system impacts of that projected surge, a landmark national plan, developed by more than 140 community, clinical and industry leaders, will be unveiled in Canberra on Thursday calling on the government to roll out sweeping preventative measures around the country.

Forbes said expanded and early use of medications such as Forxiga, Jardiance and Steglatro, and improvements in lifestyle for those with early-stage disease, meant Australia had the chance to eliminate the need for dialysis by 2050 and save $45 in healthcare costs for every $1 invested in early intervention.

The Kidney Code Red Response plan also calls on the government to begin a $10 million screening program to be delivered via GPs, aimed at everyone with known kidney disease risk factors – diabetes, high blood pressure, heart disease, family history, and those who are overweight, smokers and vapers.

“We are never going to have enough dialysis chairs,” Forbes said. “This is about turning off the tap, so we can stop people getting kidney failure or dying prematurely of something else.

“We’ve never been able to do anything about it before, but now we can, so this just makes sense. We now just need the political will and leadership to stand with us to change kidney disease for the first time in history.”

The recommendations build on a report by the Australia and New Zealand Dialysis and Transplant Registry and the Australian and New Zealand Society of Nephrology that found more than half of Australia’s dialysis units have waiting lists for new patients who need to start haemodialysis, which limits access to life-sustaining treatment.

Overflowing dialysis units and hospital renal wards are an experience Claire Neylon, 29, is all too familiar with.

The Berwick single mother first became unwell when she was 12, though it was not until she had a range of grave health issues at 18 that she was finally diagnosed with chronic kidney disease and staring down a future reliant on dialysis and, she hopes, a transplant.

“Most of my 20s were just about managing it and taking medications to make sure my blood pressure and things were under control, while hoping it didn’t get worse ... Eventually, it did,” Neylon said.

Advanced disease means Neylon is hooked up to a dialysis machine every night. She has little energy to care for her daughter, Freya, 6, let alone be able to work or have an active social life.

“It is so much to be across, but if you don’t do it, you’re not going to be here very long. You balance it, hope and pray that you get the transplant call.

“It’s very limiting. There’s not very much living; it’s just surviving.”

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