According to Diabetes Australia, 10,249 Australians living with diabetes are now undergoing kidney replacement therapy, including dialysis, each year.

More than 1.5 million Australians live with diabetes, which can lead to serious complications including kidney disease.

With diabetes patients on dialysis accounting for approximately 5% of all hospitalisations, this has a significant impact on hospital capacity countrywide.

Earlier detection of kidney disease could save the Australian economy an estimated $500M per annum.²

Pathology Awareness Australia (PAA) ambassador Professor Graham Jones, a chemical pathologist who specialises in pathology testing for kidney disease, is encouraging people living with diabetes to get regular kidney checks to prevent the onset of kidney disease. Prof Jones said:

“Laboratory tests for the detection of kidney disease are crucial as it does not show clinical symptoms in its initial stages. For people living with diabetes, regular blood and urine tests play a vital role in identifying and monitoring from early onset.

“Staying proactive by scheduling GP check-ups is important to ensure timely diagnosis of kidney disease. If caught early, effective measures can be taken to prevent or slow down further kidney damage. Neglecting the condition can lead to kidney failure, dialysis, and in some cases, a kidney transplant may be required.”

Simple blood and urine checks, along with blood pressure checks, can effectively monitor kidney function and allow for early treatment, reducing the chance that people living with diabetes will require dialysis or kidney transplant.

While more than 300 Australians with diabetes currently receive a kidney transplant every year, a huge 2,024 people living with diabetes in Australia die from kidney disease each year, a concerning number for a mostly preventable condition.

PAA, Diabetes Australia and Kidney Health Australia say it is important for people with diabetes to work with their diabetes care teams and schedule annual kidney health checks.

Justine Cain, Group CEO of Diabetes Australia, said:

“More than 10,000 Australians living with diabetes are currently undergoing kidney replacement therapy. 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.”

Kidney disease occurs when the filters inside the kidneys become damaged and can no longer filter the blood properly. This can cause waste products to build up in the body and may progress to kidney failure, which in turn requires dialysis or a kidney transplant for survival.

In its earlier stages, kidney disease can be managed by various lifestyle changes, along with medication which can slow progression. Chris Forbes, CEO of Kidney Health Australia, said:

“We are championing early detection and prevention of progression of kidney disease for all Australians, with a special focus on those at greatest risk – those living with diabetes, cardiovascular disease, and high blood pressure.

“Kidney Health Australia is leading the fight to identify the 1.8 million Australians unaware they have kidney disease and help them, and their families manage the condition more effectively from start to end. We’ve developed a holistic approach that goes beyond merely screening individuals. Early diagnosis, better treatment and support post-diagnosis go hand in hand for achieving best outcomes.

Our recent Deloitte Economics Access report exposes kidney disease as a national emergency, costing the Australian economy $9.9 billion each year, including $2.3 billion in direct costs to the health system. Now is the time to invest in kidney health, for everyday Aussies, the economy, the healthcare system, and the environment.”

Diabetes was an underlying or associated cause of death in more than 2,000 people living with chronic kidney disease in Australia in 2020.³

In the coming years, this is expected to increase due to the rising prevalence of type 2 diabetes and the strong association between it and diabetic kidney disease.⁴

According to PAA pathologist Prof Jones, regular laboratory testing for kidney damage is a key factor to improve the health of people living with diabetes.

References:

1. https://www.diabetesaustralia.com.au/wp-content/uploads/2023-Diabetes-Related-Kidney-Disease-Report-1.4-DIGITAL.pdf
2. https://kidney.org.au/uploads/resources/Changing-the-CKD-landscape-Economic-benefits-of-early-detection-and-treatment.pdf
3. Australian Institute of Health and Welfare (2023) Chronic kidney disease: Australian facts, AIHW, Australian Government, accessed 11 June 2023.
4. Reutens AT. Epidemiology of diabetic kidney disease. Med Clin North Am. 2013;97(1):1-18

Image credit: Robina Weermeijer on Unsplash

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One in three Australians are at increased risk of kidney disease according to Kidney Health Australia. There are any number of tests that can be used for screening and diagnostic purposes, involving urine and blood samples. Pathologists and  medical scientists analyse the chemical composition of these fluids in order to make a diagnosis that doctors need to help manage any conditions that might be revealed.

Tests might reveal a urinary tract infection or conditions like kidney injury or nephrotic syndrome.

If you or a loved one are diagnosed with a serious kidney disease your health provider will work with pathology to help monitor your kidney function during treatment.

Organ transplant

Late stage kidney disease may require transplant, and with one of the highest success rates for organ transplants in the world, and survival rates exceeding over 90 per cent in the first year, Australia is at the leading edge of medical transplants.

In Australia, the number of people on the waiting list for kidney transplants is usually around 1,500 at any one time, with the wait time usually over three years.

For those individuals requiring kidney transplants, and their loved ones, there are some exciting developments on the horizon.

New developments

 A recent US study based on a trial of 10 organ donors has reported that people receiving kidneys from donors infected with Hepatitis C did not themselves become ill with the virus after taking a course of antiviral medications.

The researchers tested the 10 participants 12 weeks after the drug treatment ended and did not detect Hepatitis C in their blood, although they detected antibodies to the virus in five. But if it was transmitted, transplant infectious disease specialist at Massachusetts General Hospital in Boston, Jay Fishman remains positive, saying “we can manage it”.

In another exciting development, a recent large-scale clinical trial conducted by the National Institutes of Health in the US could allow HIV-positive patients with kidney (or liver) disease to receive transplants from others affected by HIV.

While HIV infected organs are only transferrable to those also living with HIV, the transplant would not only benefit HIV-positive people but also bumps everyone else up on the organ transplant waitlist.

Both studies are great news for those on waiting lists.

Pathology’s role in kidney donation

A test known as ‘tissue typing’ is performed in pathology labs, and today’s techniques mean that DNA testing can be used to obtain the best match possible between donor and recipient. This reduces the risk of a recipient’s immune system rejecting the new organ.

Living kidney donors will also need a range of tests to check they meet health requirements and that donation will be safe for them and for the recipient. As well as the tests to determine if they are a good match, tests to check general health, kidney function and screening for certain illnesses will also be performed. With new developments such as these new studies, pathology is an integral part of monitoring the health of participants, side effects and success.

All transplant recipients need to take medication to reduce the chance of rejection and post-transplant pathology tests will be used to monitor the kidney’s function, assess how the body is responding and pathology will continue to be a part of managing their health into the future.

The post Pathology and kidney disease: from diagnosis to exciting research on transplants first appeared on Know Pathology Know Healthcare.