Chronic Kidney Disease In Australia: An Increasing Public Health Challenge (essay).

Prevalence of CKD in Australia

A challenging and increasing public health issue End-stage kidney disease (ESKD) is linked with high death, mortality, and poor access to level of life. It also has a disproportionate cost to the medical management as patients’ needs replacement therapy such as dialysis and transplantation of kidney for long-term survival.

Especially the population of Aboriginal and Torres Strait Islanders, who resides in rural part of city, are more probable to develop CKD than other Australians and are significantly worse off in health. At the national level, Aboriginal and Torres Strait Islanders' knowledge of CKD is not more than the available data. Chronic kidney disease is common among Aboriginal and Torres Strait Islanders. The first comprehensive analysis of CKD in Aboriginal Australians was published in 2011 and utilized a variety of data sources.

• Despite accounting for only 2.5% of Australia's total population, Aboriginal people accounted for almost 10% of ESKD cases treated between 2007 and 2008.
• 89% of these cases could have been prevented if Indigenous Australians with the same rates of ESKD were treated as non-Indigenous Australians.
• Compared with 45% of treated non-indigenous patients with kidney issues, only 12% of Indigenous Australians received treatment for ESKD such kidney transplantation function.

Indigenous Australians were 11 times more likely to be hospitalized for routine dialysis than other Australians in 2008-09. Indigenous Australians are approximately four times probable in dying from CRF than non-Indigenous Australians. There is an increase in the number of Indigenous Australians seeking care for ESKD up to 72 per cent between 2001 and 2008, compared with a 41 per cent development in population of non-indigenous community.

In the latest national health measure as per the survey by Australian Bureau of Statistics' (ABS) in 2011–12, an anticipated 1 in 10 people (1.7 million Australians) aged 18 and above had biological symptoms of CKD (AIHW 2014). CKD is more common as people get older, affecting about 4 out of 10 (42 percent) adults aged 75 and more. Early stages of CKD are frequently misdiagnosed since there are no obvious symptoms or pain. Only ten percent of those surveyed who showed biological markers of CKD said they had the disease.

The frequency of CKD remained steady between 1999–2000 and 2011–2012, however the quantity of Australians with mild to severe loss of kidney function approximately crumpled (in 1999–2000 these were 322,000 and reached to 604,000 in 2011–12). The rise in the elderly population (as people is living longer) and survival of advanced CKD patients receiving KRT accounted for most of the increase (AIHW 2018).  In Australia, about 5,100 new cases of EKSD were detected in 2013, equivalent to about 14 new health issues per day. KRT was given to about half of them. According to the National Death Database, CKD was responsible for approximately 16,800 deaths (11% or 1 in 9) in 2018, with 79% of these cases listed as cause-related deaths. to CKD (AIHW 2019d).

Since 2003, CRI's contribution to Australia's complete disease burden (fatal and non-fatal) has increased. CKD has high portion with 1.2% of the total burden in 2015, raised from 0.8% in 2003. The issue of CKD has raised sharply with age and is now the main issue causing the burden in people 85 years of age and older. Kidney disease, as well as gout, peripheral artery disease, Alzheimer's disease, coronary thrombosis heart disease, and stroke, are all exacerbated by relevant functions of kidney. 2.1% of the total disease burden is possible to be avoided if everyone had usual kidney management in 2015 (AIHW 2019b).

Impact of CKD on Aboriginal and Torres Strait Islanders

Action

The Kidney Disease Action Plan sets out an aim for improving kidney disease care in Australia, where quality of care and health outcomes are not determined by region, socioeconomic status, or culture. A comprehensive and coordinated set of initiatives aimed at addressing the causes of kidney chronic conditions, improving the care and support of impacted people, and building a world-class kidney research community based on patient opinion.  We also recognize the significant require to stay above “disease silos” to address the prevention of chronic diseases in a holistic and long-term manner. It also draws attention to the persistent and unidentified challenges in health and well-being between Aboriginal and Torres Strait Islanders, where kidney disease remains one of the major reason of death and disability.

Smart Goals:

Through collaboration, inclusion and impartiality, we can prevent kidney disease, assure effective care for people with kidney disease and maximize research outcomes. The target audience for the action plan includes Australian states and territories, healthcare providers and finance providers, healthcare workers, patients, analysist, and research funders. Achieving the goals of the Action Plan requires cooperative national activities and coordination at all stages of government and  health systems, along with non-governmental organizations (NGOs), businesses, academic analysist, and patient affected with disease.

 Strategies:

• The contributions of diverse groups of partners have a significant impact on the success of prevention and treatment of chronic diseases.
• Includes people, healthcare professionals and families, communities, governments at all stages, non-governmental organizations, public and private health sectors, including all healthcare providers and private health insurance companies, industry, researchers and scholars. increase.
• Kidney transplantation is a viable therapeutic option for ESKD, and this Action Plan recognizes the importance of donating organs and transplant to the kidney community.

Resources:

• Establish nationally standardized kidney transplant treatment pathways (including living donation) to ensure that people receive high-quality care irrespective of their living status.
• Increasing the number of living donor transplants.
• Implement the TSANZ Performance Report: Improving Aboriginal and Torres Strait Islander People's Access to and Outcomes of Kidney Transplantation in Australia.
• Reduce the increasing risk of renal disease among Aboriginal and Torres Strait Islander peoples.

Evaluate:

 Evaluating the output is very critical and challenging process but this process helps in analysing the effectiveness of the strategies implemented with vision of effective care. I can use surveys, analysis, interviews to identify and evaluate the outcomes;

I can observe following objectives;

• A more effective national approach to chronic disease prevention targets the major causes of chronic disease, resulting in lower rates of chronic kidney disease.
• Enhance early analysis and identification and effective management of renal failure in primary care settings by increasing awareness and understanding of renal failure.
• More efficient and effective use of health care resources, which improves access and outcomes of effective, culturally suitable and high-quality care for all Australians living in disease.
• Improve the health status and quality of life of patients with renal failure.
• Reduce the cost of living by reducing burden and morbidity.
• A concentrated kidney research program has led to continuous prevention and processing and processing continuously, as well as overcome hunting.

Training focused on the recognition and treatment of kidney disease and the link between kidney disease and other chronic diseases such as diabetes and cardiovascular disease can help raise awareness of the Australian population as a whole. The major causes leading to chronic kidney disease is likely to have high blood pressure and diabetes. Diabetes is the leading cause of chronic kidney disease in Australia. This is because hyperglycaemia damages the blood vessels in the kidneys and prevents them from properly filtering toxins. Diabetes is the cause of about 4 out of 10 cases of chronic kidney disease. Diabetic nephropathy is a term for chronic kidney disease caused by diabetes.  Kidney disease can also be caused by high blood pressure. Pyelonephritis, a kidney infection that can be hereditary or caused by an infection, can also be fatal. Education-based strategies are helpful in identifying the issues at initial level and implementing the prevention strategies to reduce risk of chronic kidney disease and challenges.

Whether they live in city, regional or remote areas, Aboriginal and Torres Strait Islander peoples have inappropriately high rates of kidney disease. They were five times more probable to develop kidney disease and 4% more likely to die from kidney failure than the general population. Renal failure is particularly common in the Aboriginal and Torres Strait Islander populations in rural and remote areas of Australia, with rates 20 times higher than in comparable non-Indigenous populations. Kidney Health Australia works to support and develop the living quality of life of Aboriginal and Torres Strait Islander people, their families and communities impacted by kidney disease in the continuum of health care. collaborate with groups of experts to collect, review and exchange culturally appropriate educational materials for Aboriginal and Torres Strait Islander peoples. Kidney-focused resources support health and educate readers about the dangers of cardiovascular disease. Providing education with help of government support to the population can help in awaking the community about issues.

References

Australian Institute of Health and Welfare. (2020). Chronic kidney disease. Retrieved from

https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease

Australian Institute of Health and Welfare. (2020). Chronic kidney disease. Retrieved from

https://www.aihw.gov.au/reports/australias-health/chronic-kidney-disease

Li, L., Guthridge, S., Li, S.Q. et al. Estimating the total prevalence and incidence of end-stage kidney disease among Aboriginal and non-Aboriginal populations in the Northern Territory of Australia, using multiple data sources. BMC Nephrol 19, 15 (2018). https://doi.org/10.1186/s12882-017-0791-3

Venuthurupalli SK, Hoy WE, Healy HG, Cameron A, Fassett RG. CKD Screening and Surveillance in Australia: Past, Present, and Future. Kidney Int Rep. 2017;3(1):36-46. Published 2017 Oct 6. doi:10.1016/j.ekir.2017.09.012