An expanded nationwide view of chronic kidney disease in Aboriginal Australians

Hoy, Wendy E., Mott, Susan A. and Mc Donald, Stephen P. (2016) An expanded nationwide view of chronic kidney disease in Aboriginal Australians. Nephrology, 21 11: 916-922. doi:10.1111/nep.12798

Author Hoy, Wendy E.
Mott, Susan A.
Mc Donald, Stephen P.
Title An expanded nationwide view of chronic kidney disease in Aboriginal Australians
Journal name Nephrology   Check publisher's open access policy
ISSN 1440-1797
Publication date 2016-11-01
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/nep.12798
Open Access Status DOI
Volume 21
Issue 11
Start page 916
End page 922
Total pages 7
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2727 Nephrology
Abstract We summarize new knowledge that has accrued in recent years on chronic kidney disease (CKD) in Indigenous Australians. CKD refers to all stages of preterminal kidney disease, including end-stage kidney failure (ESKF), whether or not a person receives renal replacement therapy (RRT). Recently recorded rates of ESKF, RRT, non-dialysis CKD hospitalizations and CKD attributed deaths were, respectively, more than sixfold, eightfold, eightfold and threefold those of non-Indigenous Australians, with age adjustment, although all except the RRT rates are still under-enumerated. However, the nationwide average Indigenous incidence rate of RRT appears to have stabilized. The median age of Indigenous people with ESKF was about 30 years less than for non-Indigenous people, and 84% of them received RTT, while only half of non-Indigenous people with ESKF did so. The first-ever (2012) nationwide health survey data showed elevated levels of CKD markers in Indigenous people at the community level. For all CKD parameters, rates among Indigenous people themselves were strikingly correlated with increasing remoteness of residence and socio-economic disadvantage, and there was a female predominance in remote areas. The burden of renal disease in Australian Indigenous people is seriously understated by Global Burden of Disease Mortality methodology, because it employs underlying cause of death only, and because deaths of people on RRT are frequently attributed to non-renal causes. These data give a much expanded view of CKD in Aboriginal people. Methodologic approaches must be remedied for a full appreciation of the burden, costs and outcomes of the disease, to direct appropriate policy development.
Keyword Chronic kidney disease
Indigenous Australian
Kidney failure
Renal replacement therapy
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 921134
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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