Call for action as diabetic kidney disease heads towards all-time high

Pictured: Professor Richard MacIsaac, Director of Endocrinology at St Vincent's Hospital Melbourne

A new report released by Diabetes Australia shows a dramatic surge in diabetes-related kidney disease across the nation, prompting urgent calls to establish an early screening program to identify people at high risk of end-stage kidney failure.

Diabetes is the most common cause of kidney disease. It occurs when kidneys are damaged and become progressively less effective at cleaning the blood of waste products. If kidney damage progresses, it can ultimately result in kidney failure which requires patients to rely on exhausting levels of dialysis to take over the function of the kidneys. 

Professor Richard MacIsaac, Director of Endocrinology at St Vincent’s Hospital Melbourne and one of the report’s lead co-authors, said routine kidney checks should be an essential part of life for people with Type 2 diabetes, and, more easily accessible.

“Limited awareness about the impact of chronic kidney disease, the complexity of the tests and the substantial demands of managing diabetes affect how and when people get their kidneys checked,” said Prof MacIsaac.

“A routine kidney check would be another piece in the puzzle of providing the full range of support that would strengthen the health of people living with diabetes.”

The Change the Future: Saving Lives by Better Detected Diabetes-Related Kidney Disease report highlights that more than one in 20 hospitalisations in Australia are linked to a person with diabetes who is undergoing dialysis. This figure is tipped to rise with end-stage kidney disease predicted to increase by 45 per cent by 2040.

Diabetes Australia Group CEO, Justine Cain, said failure to intervene early can lead to severe consequences, with kidney damage often becoming irreversible.

“There are an estimated 330,000 people living with diabetes-related kidney disease, which represents about a quarter of all people living with diabetes,” said Ms Cain.

Currently about one in four people with diabetes undergo kidney checks in the recommended time-frames – a period when early detection could allow treatments and lifestyle changes to be adopted that would help slow progression.

Prof MacIsaac said Australia is in the fortunate position of having the health infrastructure that would allow us to establish a world-leading kidney disease screening program.

“Keeping as many people off dialysis as possible is what we should be aiming for. Dialysis takes a huge toll on the quality of life. A person receiving dialysis would visit hospital more than 150 times a year to receive about 780 hours of care and that is draining on them both physically and mentally,” said Prof MacIsaac.

Pictured L-R: Federal Minister for Health, Mark Butler, Justine Cain, Group CEO of Diabetes Australia and Professor Richard MacIsaac, Director of Endocrinology at St Vincent's Hospital Melbourne

More patients to benefit with new treatment option

St Vincent’s has played a key part in research studies that are investigating ways to improve life for patients with diabetic-related kidney disease.

Among this research is the Fedelio Study, published in the New England Journal of Medicine, that investigated the use of finerenone to help slow the progression of diabetic kidney disease. St Vincent’s was one of the lead clinical trial sites involved and the trial findings supported the case for getting the drug on the Pharmaceutical Benefits Scheme (PBS).

From July 1, Kerendia (finerenone) will be funded through the PBS, making it more affordable for patients in need. The drug will be used to help delay the progressive decline of kidney function in adults with chronic kidney disease linked to Type 2 diabetes.

“The availability of Kerendia through the PBS is very welcome news,” said Prof MacIsaac, who is also a co-lead of diabetes kidney disease research at the Australian Centre for Accelerating Diabetes Innovations.

“Controlling blood sugar is very important but not enough to stop the slippery slope of diabetic kidney disease. Adopting a healthy lifestyle, having good metabolic and blood pressure control and using medications that slow progression of kidney function loss are the keys to managing kidney disease in people with diabetes,” said Prof MacIsaac.

Patients with diabetic kidney disease who would like to be assessed for their eligibility to take Kerendia as a treatment option should consult their GP.