Diabetic kidney disease in rural Australia: prevention, management, treatment and way forward

Abstract

Diabetic kidney disease is a significant microvascular complication associated with chronic diabetes, contributing substantially to the overall health burden of the disease. This perspective focusses on evaluating the most recent advancements in screening techniques, prevention, and treatment strategies along with new advances in the field. A comprehensive literature search was conducted across PubMed, Scopus and Google Scholar databases to identify and synthesize recent evidence. In Australia, chronic kidney disease (CKD) was responsible for approximately two million hospital admissions, accounting for 18% of all hospitalizations in 2021-22. In remote areas, 17,100 CKD-related hospitalizations were reported during this period, with residents being three times more likely to be hospitalized for CKD compared to those living in major cities. Among First Nations people, the burden was 7.8 times higher than that of non-Indigenous populations. Advocacy for policy changes to address healthcare disparities in rural and remote Australia is crucial.

Keywords: chronic kidney disease (CKD); diabetic kidney disease (DKD); management; prevention; rural Australia; type 2 diabetes.

Figure 1

Distribution of the Australian population by remoteness areas as defined by the Australian Bureau of Statistics (ABS).

Figure 2

Age-adjusted hospitalizations for chronic kidney disease in Australia, categorized by sex, geographic remoteness, and Indigenous status. Data sources: chronic kidney disease: Australian facts, Data–Australian Institute of Health and Welfare (aihw.gov.au). (A) Age-standardized hospitalization for CKD by sex and remoteness. (B) Age-standardized hospitalization for CKD by Indigenous Status.