TRENDS IN INCIDENCE OF END-STAGE RENAL-FAILURE IN AUSTRALIA, 1972-1991

Age-specific and cumulative incidence rates were calculated for entry into Australian end-stage renal failure programmes from 1972 to 1991, as a result of all causes, or from analgesic nephropathy, glomerulonep hritis, hypertension and vascular disease, or diabetes. Three differen t trends were demonstrated. A rising recorded incidence of renal failu re occurred throughout the period of observation in those aged 0-4 yea rs (all causes) and in those aged 55 years and over (all categories, l east in analgesic nephropathy) principally attributable to a falling f raction of patients not accepted for treatment. Falling incidence rate s indicating a real reduction in the burden of disease were seen for a nalgesic nephropathy (at least up to the age of 64 years) and hyperten sion and vascular disease (only up to the age of 54 years). In young a dults the unchanging incidence of renal failure due to all causes, glo merulonephritis and diabetes probably reflect nearly complete acceptan ce rates into end-stage renal failure programmes, and therefore approx imate the true burden of disease. In end-stage renal failure, age-spec ific or age-standardized cumulative rates are required to distinguish rising or falling incidence of disease from trends due to changing med ical practice.