Kidney Health Australia's annual State of the Nation report said the Illawarra and Shoalhaven regions on the NSW south coast ranked number one on the list of worst-affected areas.
The report said 45,000 people or 19.5 per cent of the adult population in that area were living with signs of the disease.
Sydney's Inner West was second on the list, with about 16.7 per cent of the area's adult population showing signs of the chronic disease.
Kidney Health Australia CEO Anne Wilson said Australia had 1.7 million Australian adults living with signs of kidney failure.
"We have 60 Australians dying every day from kidney-related disease — that's one person every 25 minutes," she said.
Ms Wilson said the report's results could help build a greater insight into the areas that needed the most education, awareness and health services.
Treatment of kidney disease is costs the nation more than $4 billion every year, according to the report.