Greens leader Larissa Waters to step down due to health issues

Greens leader Larissa Waters announced on Monday night she will step down due to a decline in her health.

Waters has been managing pre-existing chronic kidney disease (CKD).

“For some time now I’ve been quietly managing chronic kidney disease alongside doing the work I love. But recently it’s taken a downturn, and I need to be honest with myself about not being invincible,” she said in a statement.

Only 7.4 per cent of Australian adults self-reported having the condition. But about 14 per cent show biomedical signs of CKD. However, the disease can be asymptomatic, and many people don’t realise they have it until it’s too late for treatment.

The kidneys’ primary function is to filter the blood and remove waste products.

Jonathan Craig, vice president and executive dean of the College of Medicine & Public Health at Flinders University, explains that individuals don’t need their kidneys to function at 100 per cent but CKD occurs when kidney function deteriorates to a level that cannot keep up with the body.

“All of us pass urine, and urine contains a number of chemicals which, if left in the body, would cause damage … But as kidney function declines through a number of diseases, it reaches a level that the body is adversely impacted by the build-up of toxic waste,” Craig says.

Because the kidneys play such a vital role, CKD impacts the entire body.

“The kidneys are one of these unheralded, fabulous organs that we have that just go about their business, but if the kidneys do fail, that affects all parts of us,” Craig says.

There are many causes of kidney disease, with diabetes being the leading cause in Australia, accounting for about 36 per cent of new cases. Other causes include high blood pressure, immune diseases, congenital conditions or genetic disorders.

For a small portion of people with CKD who suffer from kidney failure, the only treatment is dialysis or organ replacement.

Craig says studies into the quality of life of people with kidney failure show it is worse than living with some cancers, and in some cases cannot be treated.

“The treatment is really just life preservation, with dialysis – that requires being attached to a machine three times a week for up to five hours a day, which is, as you can imagine, pretty brutal,” Craig says.

Most CKD is unrecognised, and kidney function can decline without signs or symptoms.

“We’re aware we have symptoms and signs that say that the body has got a problem … The problem with chronic kidney disease is that it’s slowly progressive in many cases,” Craig says.

Often it is found through a blood and urine test at a point where kidney function cannot be returned to what it was.

Symptoms that can indicate poor kidney function are general, such as tiredness, malaise and itching.

“Let’s say we start at 100 per cent of kidney function. Those symptoms might only become apparent when you are down to 20, 30, 40 per cent of kidney function. So you have to lose a lot before those symptoms become evident,” Craig says.

Chief executive of Kidney Health Australia Chris Forbes says CKD is a “silent killer”, as 50 per cent of people living with kidney disease die prematurely of a heart attack or stroke.

“A staggering 2.5 million Australians with signs of CKD have no idea they have it, putting them at serious risk of life-threatening complications,” Forbes says.

And Aboriginal and Torres Strait Islander people experience disproportionate levels of kidney disease.

“Regardless of whether they live in urban, regional or rural areas, compared with the general population, they are twice as likely to develop kidney disease and four times as likely to die from kidney disease,” Forbes says.

The rate of incidence of kidney failure in remote and very remote areas of Australia is up to 20 times higher compared to non-Indigenous people.

The general advice is to minimise the risks by living as well as possible.

“These are old and somewhat boring things like smoking and diet and physical activity and stopping diabetes, managing diabetes appropriately, controlling blood pressure appropriately.

“Some of these things we clearly can’t avoid, right? We can’t avoid ageing. We can’t avoid being born with a genetic disorder that gets passed down to us,” Craig says.

Newer diabetes drugs, like SGLT2s and GLP1s, Craig explains, have been helpful in some people with diabetes in preventing complications to the kidneys.

“There are some medications, as well as specific medications for specific kidney conditions, but those behavioural biomedical risk factors are the major issues from a population perspective.”

Prevention is key, says Forbes.

“A simple kidney health check could save your life,” Forbes says.

“We need every Australian to take this seriously. Early detection is the key to preventing kidney failure and the need for dialysis or kidney transplant.”

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