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Wednesday, 24 June 2009
Page: 4239


Senator WORTLEY (7:14 PM) —I rise to bring to the attention of senators this evening issues associated with Kidney Health Week, which recently took place nationally. I commend Kidney Health Australia for its efforts to increase awareness of chronic kidney disease in our community. The health of our kidneys is a matter that many of us rarely if ever consider. We all know, or think we know, what our kidneys do. The kidney is a surprisingly sophisticated organ. Though relatively small, normal kidneys filter nearly 200 litres of blood every 24 hours. This significant blood supply enables the kidneys to regulate the composition and pH balance of the blood, keep the volume of water in our bodies constant, remove waste products from our systems, regulate blood pressure, stimulate the production of red blood cells and maintain our calcium levels. Our kidneys quietly do this work night and day, and it is only if they malfunction that most of us give them more than a passing thought. Yet it is this silent, constant work that underpins the key messages of this year’s Kidney Health Week, ‘Make a noise about the silent killer.’

Chronic kidney disease has been called the silent killer because sufferers can lose up to 90 per cent of kidney function without the slightest warning. There may be no signs, no symptoms and there is as yet no cure. According to Kidney Health Australia, chronic kidney disease affects more than two million Australians, many of whom may not even be aware that they have the disease. I am advised that up to one in three Australians are at risk of developing some form of chronic kidney disease. Chronic kidney disease has some similarity in this regard to diabetes, which those present will recall is a long-term interest and focus of mine, particularly with the great work carried out by the Juvenile Diabetes Research Foundation.

What is the result of loss of kidney function? Figures released recently show that chronic kidney disease was a factor in more than one million hospitalisations in 2006-07 and, shockingly, in one in every 10 deaths in 2006. Between 2006 and 2007 there was an extraordinary 26 per cent rise in the number of people receiving dialysis and transplants as the result of end-stage kidney disease. In fact, dialysis has averaged a six per cent growth rate per year over the past decade. These statistics are drawn from a report by the Australian Institute of Health and Welfare entitled, An overview of chronic kidney disease in Australia, 2009. The report was released in May this year.

As for the risk indicators for chronic kidney disease, they are factors that we all know only too well. Many are closely intertwined with our 21st century lifestyle. High blood pressure, diabetes, smoking and obesity are all factors in the development of the disease, as are age and family history. People of Aboriginal or Torres Strait Islander descent are even more at risk. The Australian Institute of Health and Welfare’s report indicates that Indigenous people, who also have higher rates of diabetes, are six times more likely than non-Indigenous people to receive dialysis and kidney transplants. Keeping blood pressure down is a vital factor in managing chronic kidney disease. My research indicates that one in four Australians is affected by high blood pressure. One of the consequences of uncontrolled high blood pressure is damage to the small blood vessels in the kidney’s nephrons, or filtering units. Over time, the situation compounds and kidney function becomes more and more compromised. In turn, damaged kidneys cause blood pressure to rise because their ability to produce a certain enzyme is impacted, setting up what is effectively a very vicious circle indeed.

With diabetes, chronic kidney disease is now one of the most prevalent chronic conditions in our country. It represents an enormous health, social and financial burden for individuals living with the disease and for their families, friends and workmates, and for their communities. While dialysis is lifesaving and, of course, welcome for that reason, travelling to dialysis centres up to three times a week, spending several hours undergoing the dialysis process and then travelling home again is onerous for patients and their carers. It is onerous for children and young adults, for those in middle years and for older patients. Its adverse impact on quality of life cannot be avoided or denied. That same impact is true for self-dialysis, which, however, offers greater flexibility and independence and presents better survival rates. And then, of course, there is the kidney transplant. It is those who have had to confront this, together with their families, who know the combination of fear and hope that accompany the wait for a kidney donor, especially as the disease reaches its end stage.

It is a fact that chronic kidney disease also represents a significant cost to the community as a whole both presently and into the future. I remind senators of the increasing prevalence of the condition in our country. Kidney Health Australia has commissioned two reports into the economic ramifications of chronic kidney disease. The research was carried out in conjunction with Sydney University, the Royal Prince Alfred Hospital, the Queen Elizabeth Hospital in South Australia and the Australian and New Zealand Dialysis and Transplantation Registry. In summary, the reports show that the estimated cost to the health sector for providing renal replacement services in the period 2004-10 will be between $4.26 billion and $5.52 billion. Increasing the rate of home dialysis would produce a saving of $88.2 million and increasing the rate of transplantation produces the greatest health benefits for the least expenditure. General practice screening of 55- to 69-year-olds plus intensive management of risk factors such as diabetes and hypertension represent cost-effective strategies and are consistent with the government’s focus on the prevention and management of chronic disease.

Closer to home, though, there are simple ways in which we can all reduce our risk of chronic kidney disease. They are: losing excess weight, limiting alcohol intake according to current guidelines, taking regular exercise, reducing fat and salt intake and, of course, quitting smoking. We all know that these changes to our diet and lifestyle, as well as increased vigilance regarding our general health and regular screening checkups, offer benefits that go well beyond the avoidance of particular conditions such as chronic kidney disease or diabetes. They increase wellbeing, participation and productivity. They decrease the debilitating effects of chronic illness and the associated social and economic costs.

Making a noise about the silent killer is not just a slogan; it’s an important way in which we can recognise and deal more effectively with a condition that has an enormous impact on large numbers of Australians of all ages and of all walks of life. I hope those who are present, those who are listening and, indeed, all of those in our communities will take a moment to consider the important matter that I have spoken of this evening.