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Overview of dialysis in indigenous compared to nonindigenous Australians

Citation

Khanal, N and Clayton, P and McDonald, S and Jose, M, Overview of dialysis in indigenous compared to nonindigenous Australians, Clinical Nephrology, 86, (Supplement 1) pp. 123-127. ISSN 0301-0430 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 Dustri-Verlag

DOI: doi:10.5414/CNP86S119

Abstract

INTRODUCTION: Indigenous Australians (Aboriginal and Torres Strait Islanders, ATSI) make up 3% of the total Australian population [1] and comprised ~ 10% of new patients beginning renal replacement for end-stage kidney disease (ESKD) in Australia during 2013 [2]. In this study, we examined the differences in characteristics, incidence, and prevalence of different modalities of dialysis and survival between indigenous and nonindigenous Australians.

METHODS: We examined outcomes of all adults (aged ≥ 18 years at the start of renal replacement therapy (RRT)) in the ANZDATA registry who started RRT from 1st Jan 2003 to 31st Dec 2013 in Australia. Adjusted patient survival on dialysis was calculated using standard techniques.

RESULTS: A total of 25,528 participants were included, of whom 2,447 (9.5%) were indigenous Australians. Use of facility hemodialysis was more common among indigenous people, odds ratio (OR) 1.79 (95% confidence interval (CI), 1.37, 2.35). Of several interactions between indigenous status and other comorbidities, the most clinically significant was one with diabetes. In fully adjusted models, compared to nonindigenous with diabetes; death risk was higher for indigenous people with diabetes, HR 1.15 (95% CI, 1.06, 1.25). There was no difference between the two groups without diabetes, HR 0.86 (95% CI, 0.73, 1.05). There was no variation in the risks associated with ethnicity over year of dialysis start.

CONCLUSION: There are differences in adjusted outcomes of indigenous Australians compared to nonindigenous with ESKD. Interactions suggest that the influence of reported comorbidities may differ in this group. Further investigations will be valuable in closing the gap and improving health outcome of indigenous Australians on RRT.

Item Details

Item Type:Refereed Article
Keywords:Kidney ANZDATA Indigenous Australian
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Nephrology and Urology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Urogenital System and Disorders
Author:Jose, M (Professor Matthew Jose)
ID Code:111566
Year Published:2016
Deposited By:Medicine (Discipline)
Deposited On:2016-09-22
Last Modified:2017-11-07
Downloads:0

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