In Australia, as in most other developed countries, the incidence of end-stage kidney disease (ESKD) is increasing dramatically. Though ESKD affects fewer than 1% of the population, the high cost of renal replacement programs has brought the focus of disease management to that of chronic kidney disease (CKD), a widely prevalent but often silent condition with elevated risks of cardiovascular morbidity and mortality and a range of metabolic complications. Several programs have been instituted, or are currently underway, in Australia in order to ultimately introduce cost-effective primary prevention to reduce the overall burden of CKD. Identifying the true magnitude of CKD in the general community has been undertaken in the Ausdiab study, an extensive study that utilised biochemical analysis of approximately 11,000 non-institutionalized Australians aged over 25, and identified 1 in 7 with at least one biochemical marker of CKD. Results of a longitudinal analysis that identifies progression and incidence in this group will soon be available. Programs aimed at identifying those at greatest risk of ESKD and instituting intervention have begun in the area of primary care. These include automatic reporting of eGFR by pathology laboratories, and GP education programs that increase awareness and understanding of treatment options. People of Australiaﾕs indigenous communities have a dramatically higher rate of ESKD than the non-indigenous population. In these communities, a number of programs aimed at screening and secondary intervention have been undertaken, in addition to important primary intervention programs that are underway. Economic studies have demonstrated the importance of measures such as these in reducing the enormous burden of CKD within our community, more challenges remain. All of these programs are integral to reducing the enormous burden of CKD within our community. |