Topics
Renal disease
Reviving Living Donor Kidney Transplantation in Australia
Australia's rate of living donor kidney transplantation has stagnated. In 2024, there were 253 living donor kidney transplants, down from 354 in 2008, with the living donor rate falling to 9.5 donors per million population—well below peer nations. Despite growth in deceased donation, waiting list times continue to lengthen and can now reach 6–7years for some groups, reflecting the rising numbers of Australians living with kidney failure. Access is unequal: First Nations people receive few living donor transplants; women are more likely to donate than men but are less likely to receive a living donor transplant; and people from lower socio-economic groups are disadvantaged. Barriers include information gaps, limited multilingual resources, time-intensive workups and financial disincentives. A coordinated reset, supported by national leadership, contemporary guidance, better data and streamlined, culturally safe pathways can restore growth.
Melanie Wyld, Nicole M. Isbel, Kate Wyburn
Kidney Failure After Living Kidney Donation in Australia: A National Registry Linkage Study, 2004-2024
National linkage of the Australia and New Zealand Living Kidney Donor Registry and the Australia and New Zealand Dialysis and Transplant Registry provides the first Australian estimates of kidney failure treated with kidney replacement therapy (KRT) after living kidney donation (2004–2024). Out of 5291 donors (56,962 person-years; median follow-up, 10.96years), three donors underwent KRT (0.53 per 10,000 person-years). No events occurred within 10years of donation. Australian clinicians can now counsel and guide potential donors using local data: risk of kidney failure requiring KRT is very low, but late events warrant lifelong follow-up.
Melanie Wyld, Kate Wyburn
Chronic Kidney Disease and Unmet Needs for Comprehensive Rehabilitation in Australia
Chronic kidney disease (CKD) affects over 2 million Australians and imposes substantial clinical, societal and economic burdens. A pervasive yet under-recognised consequence is progressive muscle loss and functional decline, manifesting as sarcopenia and frailty, which are highly prevalent across CKD stages and strongly associated with hospitalisation, disability and mortality. Although exercise-based interventions improve physical function, quality of life and cardiovascular risk profiles, access and participation remain limited. Furthermore, compared with cardiac and pulmonary rehabilitation, funding for CKD-specific allied health services is fragmented and inadequate, with no dedicated funding pathways. Strategic policy reform is urgently needed to embed renal rehabilitation into standard kidney care.
Limy Wong, Lawrence P. McMahon
