What is Kidney Disease?

Kidney disease encompasses a range of conditions that affect kidney function, including chronic kidney disease (CKD), acute kidney injury, polycystic kidney disease, kidney stones, and glomerulonephritis. The kidneys filter waste products and excess water from the blood to form urine, regulate blood pressure, produce red blood cells, and maintain the body's chemical balance. These vital functions become impaired when the kidneys are damaged.

Kidney disease affects approximately 1.7 million Australians, with chronic kidney disease most prevalent. Many people with early-stage kidney disease are unaware of their condition, as symptoms often don't appear until significant kidney damage has occurred. Kidney disease predominantly affects adults over the age of 45.

Chronic kidney disease is classified into five stages based on estimated glomerular filtration rate (eGFR), ranging from mild kidney damage (Stage 1) to kidney failure requiring dialysis or transplantation (Stage 5). Early stages are often asymptomatic, while advanced stages present with fatigue, fluid retention, bone disease, and cardiovascular complications. With proper management, progression can be slowed significantly, allowing many people to maintain their everyday lives.

Risk Factors

Diabetes is the leading cause of kidney disease in Australia, accounting for approximately 40% of all cases requiring dialysis. High blood pressure is the second most common cause, contributing to or resulting from kidney damage.

These conditions often coexist and accelerate kidney function decline when poorly controlled. Age significantly increases the risk, with kidney function naturally declining after the age of 40, although this rarely progresses to kidney failure without additional risk factors.
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Family history of kidney disease, particularly polycystic kidney disease and some forms of glomerulonephritis, substantially increases individual risk. Cardiovascular disease and kidney disease are closely linked, with each condition increasing risk for the other.

Smoking accelerates kidney function decline and worsens outcomes in existing kidney disease.

Obesity stresses kidney function and also contributes to diabetes and hypertension. Autoimmune conditions such as lupus and vasculitis can cause kidney inflammation and damage, while infections, including hepatitis B and C, can progress to kidney disease if untreated.

Workplace-specific risks include exposure to heavy metals such as lead, cadmium, and mercury, as well as solvents, silica dust, and certain chemicals used in manufacturing, mining, and agriculture. Dehydration from working in hot environments or inadequate fluid access can cause acute kidney injury and contribute to chronic damage over time.

Impact on the workplace

Kidney disease significantly impacts workplace productivity through increased absenteeism for medical appointments, dialysis treatments (typically 3 times weekly for 4 hours), and complications management. Advanced kidney disease causes fatigue, cognitive changes, and reduced physical capacity, which can affect work performance.

Workplace accommodations that support employees include flexible scheduling for dialysis treatments and medical appointments, modified duties to accommodate fatigue and physical limitations, access to frequent breaks and hydration, ergonomic adjustments for employees with arteriovenous fistulas or peritoneal dialysis catheters, and private areas for blood pressure monitoring or medication administration.

For employees on dialysis, scheduling flexibility is crucial as treatment schedules are typically fixed and non-negotiable. Post-dialysis fatigue often requires rest periods or modified duties on treatment days. Access to parking close to building entrances helps manage fatigue and mobility limitations.

Impact on the Workplace

Physical Activity

Physical activity offers numerous benefits for kidney health, including the control of blood pressure, management of blood glucose levels, maintaining a healthy weight, and enhancing cardiovascular health. Regular exercise slows the decline in kidney function and reduces cardiovascular complications common in kidney disease. Even modest levels of activity provide substantial benefits.

Muscle-strengthening

Muscle-strengthening exercises help maintain muscle mass and strength, which are often compromised in advanced kidney disease. Strength training also improves insulin sensitivity, helping manage diabetes-related kidney damage. For dialysis patients, strength training exercises help maintain functional capacity and quality of life.

Sedentary Behaviour

Sedentary behaviour management is essential as prolonged inactivity worsens the cardiovascular complications associated with kidney disease. Regular movement helps maintain circulation and prevents the muscle wasting that commonly accompanies chronic kidney disease.

Fruit & Vegetable Intake

Fruit and vegetable intake is generally beneficial for preventing kidney disease. Early-stage kidney disease can benefit from the anti-inflammatory and antioxidant properties of plant foods, which may slow its progression. Advanced kidney disease may necessitate restrictions on potassium-rich foods, including fruits and vegetables.

Sugar & Saturated Fat

Managing sugar and fat intake is crucial for preventing and managing diabetes-related kidney damage. Controlling blood glucose levels can significantly slow the progression of kidney disease. Limiting processed foods also helps control sodium and phosphorus intake, which are essential in advanced kidney disease.

Managing Alcohol Intake

Alcohol intake management is essential as excessive consumption can worsen high blood pressure and interfere with medications commonly prescribed for kidney disease. Alcohol can also contribute to dehydration and electrolyte imbalances that stress kidney function.

Mindfulness Practices

Mindfulness and controlled breathing practices help manage the stress and anxiety associated with chronic kidney disease diagnosis and treatment. Stress reduction may also help control blood pressure, a crucial factor in slowing the progression of kidney disease.

Sleep Habits

Quality sleep habits support overall health maintenance, which is vital for kidney disease management. Poor sleep affects blood pressure control and glucose metabolism, both of which are crucial factors in the progression of kidney disease.

Impact on the Workplace

Workplace accommodations that support employees include flexible scheduling for dialysis treatments and medical appointments, modified duties to accommodate fatigue and physical limitations, access to frequent breaks and hydration, ergonomic adjustments for employees with arteriovenous fistulas or peritoneal dialysis catheters, and private areas for blood pressure monitoring or medication administration.

For employees on dialysis, scheduling flexibility is crucial as treatment schedules are typically fixed and non-negotiable. Post-dialysis fatigue often requires rest periods or modified duties on treatment days. Access to parking close to building entrances helps manage fatigue and mobility limitations.

Resources & Tools

Cancer Australia

Comprehensive cancer information, risk assessment tools,
screening guidelines, and workplace resources for employees
and employers managing cancer in the workplace.

Cancer Council Australia

Prevention guidelines, support services, workplace cancer
policies, and the "SunSmart" program for skin cancer prevention
in outdoor workers. Their 13 11 20 helpline provides information
and support services.