CKD Screening and Surveillance in Australia: Past, Present, and Future

Abstract

Chronic kidney disease (CKD) was largely a hidden health problem until the publication of an internationally agreed approach to its identification, monitoring, and treatment. The 2002 National Kidney Foundation CKD classification and the subsequent 2006 Kidney Disease Improving Global Outcomes (KDIGO) recommendations are powerful tools for translating thinking about CKD into clinical practice. These guidelines were strongly endorsed by the international community, including Australia, and were incorporated into CKD practice guidelines. In the past, CKD research studies in Australia focused on screening the general population, and more specifically, individuals at risk for CKD. Information from these studies led to the recognition that the CKD burden in Australia is a public health problem and contributed to the development of national health policies and priorities. At present, apart from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) that reports on CKD patients undergoing renal replacement therapy (RRT), long-term surveillance to describe the natural history of the CKD population not on RRT has only recently started. Entities such as CKD. Queensland and the Western Australian Nephrology Database are able to fill the gap and provide opportunities for collaborative research of CKD in Australia. Establishment of a National Health and Medical Research Centre−funded CKD Centre of Excellence in 2015 and the Better Evidence and Translation–Chronic Kidney Disease in 2016 are likely to change the future of CKD surveillance and research in Australia.

Metformin: time to review its role and safety in chronic kidney disease

“…Diabetes mellitus, both type 1 and type 2, has long been associated with an increased risk of cardiovascular morbidity and mortality . This heightened mortality risk among people with diabetes is, in part, due to the higher incidence of CKD, and cardiovascular disease (CVD) observed in this population . The risk of a fatal vascular event is two‐ to threefold higher in people with diabetes compared with those without the disease …”

Mortalidad de personas con insuficiencia renal crónica, en el Instituto Salvadoreño del Seguro Social 2000-2016

“…Para diabetes mellitus se encontró relación con IRC en promedio de 34.5%, contrario al 4.2% reportado en Chile en 2010-2012 e inferior a los datos de México en 2013-2015, que fue de 72.5%. Otras referencias importantes la reportan con rangos intermedios del 25% como en Queensland, Australia, en 2017 11 .…”

Role of Artificial Intelligence in Kidney Disease

“…Computer Aided Diagnosis (CAD) is a technology combined medical image and computer image processing to quantify and judge the characteristics of the focus, could assist clinicians to identify and analyze lesions timely and accurately [32]. The function of CAD has been verified in many aspects, especially in tumors, such as skin cancer, breast cancer, lung cancer, and so on [33].…”