Renal-related deaths in Australia 1997-1999

Background: Despite marked increases in cases of treated end-stage renal disease in Australia, little is known about renal disease mortality. Aims: To quantify the contribution of renal diseases to mortality in Australia and to explore the relationship between renal disease and other common diseases as causes of death. Methods: Data from the Australian Bureau of Statistics on underlying and associated causes of death (based on death certificates) were examined for deaths occurring in 1997-1999 and registered by the end of 1999. Causes of death were coded according to the International Classification of Diseases, 10th Revision (ICD-10). Several causes outside the ICD-10 chapter on diseases of the genito-urinary system (e.g. diabetic renal disease, hypertensive renal disease and congenital malformations of the kidney) were included as renal. Results: Of 378 832 recorded deaths, renal disease was coded as the underlying cause for 7888 (2.1%) and as an associated cause for an additional 28 012 (7.4%). Almost all renal deaths (98.4%) had at least one other cause of death recorded on the death certificate. Conclusions: The contribution of renal disease to Australian mortality has been underestimated because of historical reliance on a single (underlying) cause of death. Deaths involving renal disease usually occur in the context of multiple coexisting chronic and/or acute conditions.