CHRONIC KIDNEY DISEASE (CKD) BIOMARKERS

Kidney disease is a chronic disease in which a person's kidney function is impaired or damaged. This affects the kidney's ability to filter blood and therefore control the body's water and other hormone levels, leading to increased fluid and waste within the body. This can cause high blood pressure, anaemia, and uremia. Kidney disease is also associated with several other chronic diseases such as diabetes and cardiovascular disease, and was the tenth leading cause of death in Australia in 2011.¹

The indicators of kidney disease that were measured in the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS) were estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (ACR). Chronic Kidney Disease (CKD) stages were determined by combining the participants' estimated glomerular filtration rate (eGFR) results with their albumin creatinine ratio (ACR) results. The different stages were defined as follows:

• No indicators of chronic kidney disease - eGFR ≥60 mL/min/1.73 m² and no presence of albuminuria
• Stage 1 - eGFR ≥90 mL/min/1.73 m² & albuminuria
• Stage 2 - eGFR 60–89 mL/min/1.73 m² & albuminuria
• Stage 3a - eGFR 45–59 mL/min/1.73 m²
• Stage 3b - eGFR 30–44 mL/min/1.73 m²
• Stage 4–5 - eGFR <30 mL/min/1.73 m².

It is important to note that while abnormal eGFR or ACR test results in the NATSIHMS may indicate impaired kidney function, they cannot provide a diagnosis for kidney disease based on a single test alone. Kidney disease can only be confirmed if albuminuria or eGFR of less than 60 mL/min/1.73 m² is persistent for at least three months.² For more information about these tests, see the relevant eGFR and ACR topic pages of this Users' Guide.

Self reported data on kidney disease was also collected in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS). The biomedical results from the NATSIHMS can be used together with the self reported data to estimate disease prevalence rates. For details on self reported kidney disease data, see the relevant Kidney Disease page in this product.

Comparability with other surveys

The NATSIHMS is the first ABS Aboriginal and Torres Strait Islander survey to collect biomedical information. Given it was also the first national level survey (ABS or otherwise) to collect such data for the Aboriginal and Torres Strait Islander population, no comparisons with previous surveys for this population are possible.

However, biomedical data was also collected for all Australians in the 2011-12 National Health Measures Survey (NHMS) and information about comparisons between the NHMS results and those of non-ABS surveys is available from the Comparisons with other Australian surveys section of the Biomedical Results for Chronic Diseases, 2011-12 publication.

More information regarding the biomedical tests and cut off points can be found in the relevant subsections of this Users' Guide.

ENDNOTES

1 Australian Bureau of Statistics 2013, Causes of Death Australia, ABS cat. no. 3303.0, <https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0Chapter42011>, Last accessed 08/09/2014.
2 Kidney Health Australia 2013, Chronic Kidney Disease (CKD) Management in General Practice. 2nd Edition 2012 <http://www.kidney.org.au//LinkClick.aspx?fileticket=vfDcA4sEUMs%3d&tabid=635&mid=1584>, Last accessed 08/09/2014.

This section contains the following subsection :

Estimated Glomerular Filtration Rate (eGFR)

Albumin/Creatinine ratio (ACR)

Albumin

Creatinine

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