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Healthy kidneys help the body by removing waste and extra water, and keeping the blood clean and chemically balanced . When the kidneys stop working properly - as is the case when someone has kidney disease - ‘waste' can build up in the blood and damage the body. Chronic kidney disease (CKD) is when the kidneys gradually stop working . End-stage kidney disease (ESKD) is when the kidneys have totally or almost totally stopped working. People with ESKD must either have regular dialysis (be hooked up to a machine that filters the blood) or have a kidney transplant to stay alive.
ESKD affects Indigenous people when they are much younger than it does among non-Indigenous people. Almost two-thirds of Indigenous people diagnosed with kidney disease in 2006-2010 were younger than 55 years of age (less than one-third of non-Indigenous people were younger than 55 years of age) (Figure 5) (Derived from ).
Figure 1. Rates (per million) of end-stage kidney disease for Indigenous and non-Indigenous people, by age-group (years) 2006-2010
Source: Derived from ANZDATA, 2011 , ABS, 2008 , ABS, 2001 , ABS, 2009 
Dialysis was the most common reason for Indigenous people to be admitted to hospital in 2010-11 . Almost one-half of all Indigenous hospital admissions were for dialysis. Indigenous people were admitted to hospital for dialysis around 11 times more often than were other Australians.
Some people need to have dialysis every day. Dialysis can be undertaken at hospitals, special out-of-hospital satellite units, or in the home (which requires special equipment and training for the patient and their carer(s), and is very costly) . Accessing dialysis can sometimes be very difficult for Indigenous people who live in rural or remote locations and they may have to travel to receive treatment.
In 2006-2010, Indigenous people were four times more likely to die from kidney disease than were non-Indigenous people .