HISTORICAL AND CONTEMPORARY BURDEN OF END STAGE KIDNEY DISEASE AMONG TORRES STRAIT ISLANDER PEOPLE OF AUSTRALIA, 1963-2022
Prof. Jaqui Hughes1, Ms KATIE CUNDALE1, Assoc Professor SHAHID ULLAH2, Assoc Professor KARLA J CANUTO1
1Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Darwin, Australia, 2College of Medicine and Public Health, Flinders University, Adelaide, Australia, Bedford Park, Australia
Aim: To describe the patterns, modality and outcomes of kidney replacement therapy (KRT) among Zenadh (Torres Strait Islander) people.
Background: Zenadh people, oppressed by colonisation and systematic racism, experienced sustained barriers to healthcare, and live with advanced diabetes and kidney disease. They sought nationally representative health information describing where, how, and why kidney care is accessed and utilised, to inform health improving actions.
Methods: Data was extracted from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry that included demographic details (age, sex, location), primary disease, comorbidities, and treatment modality. Adults (≥18 years) who commenced KRT in Australia between 1963 and 2022 were included, and we describe patients with the ethnicity identifier of “Torres Strait Islander”. The research and its conduct was approval by Maluilgal Tribal Governance and an Indigenous Health Ethics Committee.
Results: A total of 453 Zenadh adults received KRT during 1963-2022 with an average commencement age of 54 (SD=12.3) years and 55% were female. The most recent decade accounted for 42% (190/453) of KRT initiation, and the majority of patients overall were resident of Queensland (92%, 418/453). Diabetic kidney disease was the primary kidney disease in most patients (75%, 341/453). Forty seven (10%) transplants occurred since 1978. For Zenadh patients still alive at 31 Dec 2022, satellite and hospital haemodialysis (51% and 26%) were the two most common modality, and transplantation was 9%.
Conclusions: We present data specific to treatment for kidney failure of the Zenadh people who live across Australia during 1963-2022. This first look into the historical and contemporary burden of kidney disease, establishes baseline health statistic whereby health improving actions will be progressed.
Biography:
Prof Jaquelyne Hughes is a Torres Strait Islander woman, a senior staff specialist (nephrology), at Royal Darwin Hospital, on Larrakia Country, and Clinical Research Professor Aboriginal and Torres Strait Islander Health Advancement, Flinders University (Darwin, NT). Hughes co-leads a clinical model of care encompassing remote-island kidney health optimisation, and transition support after dialysis initiation. Hughes leads a clinical research program at Flinders University including describing long-term kidney health (the eGFR3 Study), sustainable access to kidney transplantation (NIKTT), and enabling health-provider assisted on-country haemodialysis.