Nephrology in Australia

In Australia, hospitalisations attributed to acute kidney injury are increasing at an average 6% per annum, and the vast majority of these cases are managed by critical care physicians instead of nephrologists. Prevalence of chronic kidney disease varies from 4.5% to 43.3% according to age and gender. As in other countries, most are unaware of their kidney disease. The number of people receiving maintenance dialysis has steadily increased in the last two decades with over 13,000 people on dialysis in 2017. The incidence of haemodialysis is approximately fivefold higher for Indigenous Australians compared to non-Indigenous Australians, and the magnitude of this difference has not changed in the last decade. Australia has the second highest prevalence of home haemodialysis and the fifth highest utilisation of peritoneal dialysis in the world. In recent years, average waiting time for a kidney transplant has shortened to 2.4 years for the most common blood group. Emerging paradigms in Australian nephrology include "green nephrology" and exploring different approaches to the burden of chronic kidney disease. Australia has a vibrant kidney research community, and the immediate future promises to be an incubator for nephrology clinicians who have ideas to test in our clinical spaces.