A/Prof. Pedro Franca Gois1,2, Dr Namrata Khanal3, A/Prof Kamal Sud4,5, Prof Bobby Chacko1,6, Dr Ginger Chu6, Dr Scott Jones1, Dr Tim Spicer7, Dr Chandana Guha8, Mr Shyam Muthuramalingam9, Ms Jasmin Mazis10, Prof Stephen McDonald10,11,12
1Nephrology and Transplantation, John Hunter Hospital, Newcastle, Australia, 2The University of Queensland, Brisbane , Australia, 3St Vincent’s Hospital, Sydney , Australia, 4Nepean Hospital, Kingswood, Australia, 5The University of Sydney, Kingswood , Australia, 6The University of Newcastle, Newcastle, Australia, 7South West Sydney Local Health District, Sydney, Australia, 8The University of Sydney, Sydney , Australia, 9South Australia Health, Marden, Australia, 10Australia and New Zealand Dialysis and Transplant Registry, Adelaide , Australia, 11Royal Adelaide Hospital, Adelaide , Australia, 12The University of Adelaide, Adelaide, Australia
Biography:
A/Prof Franca Gois is a mid-career clinician and researcher with medical training across Europe, South America, and Australia. He currently works as a Consultant Nephrologist at the John Hunter Hospital and holds a Level D academic appointment at the University of Queensland. His research spans basic, clinical, and translational nephrology, contributing to international guidelines and practice changes. He has secured national and international research funding, authored over 60 publications, and serves on editorial boards and global working groups.
Aim:
To evaluate patient characteristics and outcomes of culturally and linguistically diverse (CALD) individuals receiving Kidney Replacement Therapy (KRT) in Australia over the past two decades.
Background:
Australia is one of the world’s most culturally and linguistically diverse nations, yet research on KRT outcomes among CALD populations remain limited.
Methods:
We analysed data from the ANZDATA registry for non-Indigenous adults who initiated KRT in Australia from 2002-2023. Patients were grouped by place of birth: Australia/New Zealand (Aus/NZ), other English-speaking countries (CALD-English), and non-English-speaking countries (CALD-non-English). We used chi-squared tests and multivariable competing-risks regression to assess characteristics and outcomes, including mortality and transplant waitlisting.
Results:
Among 52,045 patients (64% male, mean age 62±15 years), 63.8% were Aus/NZ-born. CALD-non-English had higher rates of diabetic kidney disease and lower rates of pre-emptive transplantation. CALD-English were older (66±13 years) and had more comorbidities. White individuals were the most reported ethnic group across all categories, while CALD-non-English included substantial representation from Asian, European, and Pacific Islander backgrounds. Significant predictors of waitlisting and mortality included age, comorbidities, smoking status, body mass index, socioeconomic disadvantage, and remoteness. After adjustment, CALD-non-English were more likely to be waitlisted (SHR 1.33, 95% CI 1.28–1.40) and had lower mortality (SHR 0.76, 95% CI 0.74–0.78) (p<0.001). Most ethnic groups had lower mortality than White individuals. However, Pacific Islanders (SHR 2.17, 95% CI 1.64–2.88, p<0.001) and Europeans (SHR 1.34, 95% CI 1.04–1.72, p=0.02) in the CALD-English group had higher mortality compared to non-CALD White individuals.
Conclusions:
CALD status and ethnicity influence KRT outcomes in Australia. While CALD-non-English appear to experience survival and waitlisting advantages, we identified some vulnerable ethnic subgroups. These disparities warrant targeted research and policy responses.