McKercher, C and Chan, HW and Clayton, PA and McDonald, S and Jose, MD, Dialysis outcomes of elderly Indigenous and non-Indigenous Australians, Nephrology, 19, (10) pp. 610-616. ISSN 1320-5358 (2014) [Refereed Article]
Copyright 2014 Asian Pacific Society of Nephrology
Aim: Whilst increasing numbers of elderly people in Australia are commencing dialysis, few Indigenous patients are aged ≥65 years and their outcomes are unknown. We compared the long-term survival, mortality hazards and causes of death between elderly Indigenous and elderly non-Indigenous dialysis patients.
Methods: This was a retrospective cohort study of adults aged ≥65 years who commenced dialysis in Australia from 2001-2011, identified from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Indigenous (n = 263) and non-Indigenous (n = 10713) patients were followed until death, loss to follow-up, recovery of renal function or 31 December 2011. Mortality was compared using a multivariate Cox proportional-hazards model with age, gender, body mass index, smoking, primary renal disease, comorbidities, late referral and initial treatment modality as predictive variables.
Results: Median follow-up was 26.9 months (interquartile range 11.3–48.8 months). Overall 166 Indigenous and 6265 non-Indigenous patients died during the 11-year follow-up period. Mortality rates per 100 patient-years were 23.9 for Indigenous patients and 21.2 for non-Indigenous patients. The overall 1-, 3- and 5-year survival rates were 81%, 49% and 27% for Indigenous patients and 82%, 55% and 35% for non-Indigenous patients respectively. Indigenous patients had a 20% increased risk of mortality compared with non-Indigenous patients (adjusted hazard ratio [HR] 1.20, 95% CI, 1.02, 1.41; P = 0.02). "Social deaths" (predominantly dialysis withdrawal) and cardiac deaths were the main causes of death for both groups.
Conclusion: Among elderly dialysis patients in Australia, Indigenous status remains an important factor in predicting survival.
|Item Type:||Refereed Article|
|Keywords:||Australia, aged, population groups, renal replacement therapy, treatment outcome, indigenous kidney disease|
|Research Division:||Health Sciences|
|Research Field:||Epidemiology not elsewhere classified|
|Objective Group:||Aboriginal and Torres Strait Islander health|
|Objective Field:||Aboriginal and Torres Strait Islander health status and outcomes|
|UTAS Author:||McKercher, C (Dr Charlotte McKercher)|
|UTAS Author:||Chan, HW (Dr Hoi Chan)|
|UTAS Author:||Jose, MD (Professor Matthew Jose)|
|Web of Science® Times Cited:||6|
|Deposited By:||Menzies Institute for Medical Research|
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