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 Health Measures Survey (NHMS) 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 NHMS 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.

Self reported data on kidney disease was also collected in the National Health Survey (NHS) and the National Nutritional and Physical Activity Survey (NNPAS). The biomedical results from the NHMS 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 chapter in this product.

Comparability with other surveys

The NHMS is the first ABS survey to collect biomedical data on Chronic Kidney Disease.

Chronic Kidney Disease biomedical data has been collected in other non-ABS surveys. However, caution must be taken when interpreting results due to the differences in scope, assay and the instrument used, and any thresholds applied in the final analysis. Further information about these comparisons 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.

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 02/07/2013.
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 02/07/2013.

This section contains the following subsection :

Estimated Glomerular Filtration Rate (eGFR)

Albumin/Creatinine ratio (ACR)

Albumin

Creatinine

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