Chronic kidney disease in Tasmania

Aim: Chronic kidney disease (CKD) is a progressive disease which is becoming a major public health issue due to its high rate of premature death, poor quality of life and expensive end-stage treatment (dialysis or transplantation). The burden of this chronic condition in a community setting was examined. Methods: Data were obtained from 369 098 Tasmanian adults (aged 318 years) and included 1 640 687 measurements of creatinine taken between 1995 and 2007. In 2007 alone, testing comprised 25.5% of the state’s adult population. A modelled estimate of CKD prevalence was developed. Results: For those at risk of CKD (aged >50 years), 50.6%, 70.2% and 82% had a measured creatinine (and reported estimated glomerular filtration rate (eGFR)) during the last 1, 2 and 3 years respectively. However, only 9.4% of people with eGFR of less than 60 mL/min per 1.73 m2 had albuminuria formally measured. Estimated prevalence of stage III or greater CKD (eGFR <60 mL/min per 1.73 m2) was at least 11.4% of women and 8.6% of men during 2007. Detection of low eGFR increased significantly over the last 13 years. There was a large geographic variation throughout Tasmania and high relative mortality with lower eGFR. There is a broad gap between the number of people with eGFR of less than 15 mL/min per 1.73 m2 (stage V CKD) and those receiving dialysis treatment. Conclusion: The number of people identified with low eGFR has increased significantly since 1995 with a large geographic variation. Despite this, testing for kidney disease (by measuring serum creatinine and albuminuria) in people at risk is still suboptimal.