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Gender differences in the dialysis treatment of Indigenous and non-Indigenous Australians

Citation

McKercher, C and Jose, MD and Grace, B and Clayton, PA and Walter, M, Gender differences in the dialysis treatment of Indigenous and non-Indigenous Australians, Australian and New Zealand Journal of Public Health, 41, (1) pp. 15-20. ISSN 1753-6405 (2017) [Refereed Article]


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Copyright 2016 the authors. Licenced under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/

DOI: doi:10.1111/1753-6405.12621

Abstract

Objective: Access to dialysis treatment and the types of treatments employed in Australia differs by Indigenous status. We examined whether dialysis treatment utilisation in Indigenous and non-Indigenous Australians also differs by gender.
Methods: Using registry data we evaluated 21,832 incident patients (aged ≥18 years) commencing dialysis, 2001-2013. Incidence rates were calculated and multivariate regression modelling used to examine differences in dialysis treatment (modality, location and vascular access creation) by race and gender.
Results: Dialysis incidence was consistently higher in Indigenous women compared to all other groups. Compared to Indigenous women, both non-Indigenous women and men were more likely to receive peritoneal dialysis as their initial treatment (non-Indigenous women RR=1.91, 95%CI 1.55-2.35; non-Indigenous men RR=1.73, 1.40-2.14) and were more likely to commence initial treatment at home (non-Indigenous women RR=2.07, 1.66-2.59; non-Indigenous men RR=1.95, 1.56-2.45). All groups were significantly more likely than Indigenous women to receive their final treatment at home.
Conclusions: Contemporary dialysis treatment in Australia continues to benefit the dominant non-Indigenous population over the Indigenous population, with non-Indigenous men being particularly advantaged.
Implications for Public Health: Treatment guidelines that incorporate a ecognition of genderbased preferences and dialysis treatment options specific to Indigenous Australians may assist in addressing this disparity.

Item Details

Item Type:Refereed Article
Keywords:dialysis, end-stage kidney disease, gender, Indigenous population, inequalities
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:McKercher, C (Dr Charlotte McKercher)
Author:Jose, MD (Professor Matthew Jose)
Author:Walter, M (Professor Maggie Walter)
ID Code:113277
Year Published:2017 (online first 2016)
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-12-19
Last Modified:2017-03-22
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