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End‐stage renal disease in Aboriginals in New South Wales: a very different picture to the Northern Territory
Author(s) -
Cass Alan,
Gillin Adrian G,
Horvath John S
Publication year - 1999
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1999.tb123718.x
Subject(s) - incidence (geometry) , medicine , end stage renal disease , demography , dialysis , socioeconomic status , disease , renal replacement therapy , pediatrics , surgery , population , environmental health , physics , sociology , optics
Objectives To compare the incidence of end‐stage renal disease (ESRD) among Aboriginals in New South Wales with the incidence among Aboriginals in the Northern Territory, and to compare the patterns of ESRD among Aboriginals and non‐Aboriginals in NSW. Design Secondary data analysis of information from unpublished and published Australia and New Zealand Dialysis and Transplant Registry reports. Main outcome measures Average annual incidence of ESRD (persons per million); form of renal replacement therapy; mortality at 31 March 1998; patient and graft survival one and five years after transplant. Results Each year in NSW, 5–17 new Aboriginal patients are treated for ESRD. There was no increase in the average annual incidence of ESRD among NSW Aboriginals (118 per million in 1988–1989 and 111 per million in 1996–1997), whereas incidence in the NT increased from 255 per million to 800 per million. In NSW, ESRD was attributed to diabetes in 32% of Aboriginal patients, compared with 13% of non‐Aboriginal patients ( P <0.001). In NSW, Aboriginal patients were younger and more likely to be female, a pattern similar to that in the NT. The outcome of ESRD treatment is not significantly different between Aboriginals and non‐Aboriginals in NSW. Conclusion There is a different pattern of incidence of ESRD and of outcomes with treatment among Aboriginals in NSW compared with those in the NT. A possible explanation is that the lower incidence in NSW reflects less profound socioeconomic disadvantage and better access to primary and specialist care.