Changing the chronic kidney disease landscape

Around two million Australians are living with CKD, yet only 10% of these individuals with biomedical signs of CKD are aware of their condition. The silent nature of CKD means that an individual can lose up to 90% of kidney function before symptoms are apparent, making it too late to stop or even slow down their deterioration. Currently, more than 30,000 Australians are living with kidney failure, many of whom are undergoing kidney replacement therapy (dialysis and kidney transplant).

It was estimated that CKD is currently costing the Australian economy $9.9 billion per year, equivalent to nearly $5,000 per person living with the condition. This cost per person rises drastically throughout the CKD stages, from just $50 per person in early stage CKD to more than $182,000 per person with kidney failure. The major impacts contributing to the cost of CKD were productivity-related (reduced workforce participation, absenteeism and presenteeism, and foregone future income due to premature death) and direct healthcare expenditure. The greatest portion of the cost to the health system comes from the provision of dialysis and kidney transplants to people with kidney failure.

Investment in early detection could identify an additional 400,000 cases of CKD in its earlier stages. The provision of best practice treatment to these individuals would drastically improve the disease trajectory of many of these individuals. The result would be the avoidance of 38,200 premature deaths as well as 123,144 fewer person years lived on dialysis and 175,524 fewer person years living with a transplant over the next 20 years.

These benefits translate into significant savings across the health system. Over the next 20 years, health system expenditure on kidney failure would be $6.9 billion lower, and there would be a further saving of $3.3 billion from reduced occurrence of CKD-related cardiovascular disease hospitalisations. This represents a total saving of $10.2 billion over the next 20 years ($509 million annually), or a per person saving of over $25,000. Overall, each dollar invested in early detection was estimated to generate $45 in savings from the avoidance of costs related to the management of kidney failure over the next 20 years.