Dr Jessica Fraser1, ZENA BARAKAT2, HILARY HISCOCK3, ALEX KITSOS4, TIM SAUNDER4, KIM JOSE5, RAJESH RAJ6, JAN RADFORD7, MATTHEW JOSE3,4
1Launceston General Hospital, Launceston, Australia, 2Renal Unit, Monash Medical Centre, Clayton, Australia, 3Renal Unit, Royal Hobart Hospital, Hobart, Australia, 4Tasmanian School of Medicine, University of Tasmania, Hobart, Australia, 5Menzies Institute for Medical Research, Hobart, Australia, 6Renal Unit, Launceston General Hospital, Launceston, Australia, 7Launceston Clinical School, Tasmanian School of Medicine, University of Tasmania, Launceston, Australia
Biography:
Basic Physician Trainee at the Launceston General Hospital in Tasmania
Aim:
To examine the sociodemographic factors contributing to variation in the increasing prevalence of chronic kidney disease (CKD) in rural and remote communities.
Background:
The burden of CKD is growing worldwide with disproportional regional variation. Tasmania has the highest state prevalence of CKD in Australia, yet there is significant variation between communities. We hypothesised that sociodemographic factors contribute to this variation.
Methods:
We analysed self-reported socioeconomic data from the 2022 Tasmanian Population Health Survey and compared it to the CKD.TASlink dataset, which included 569,481 Tasmanian adults (88.4% of adults in the state) with a serum creatinine measurement from 01/01/2004-31/12/2023. Of these, 53% were female. Rurality was classified using the Modified Monash Model (MMM).
Results:
In 2023 the age-standardised prevalence of CKD varied from 3.8% to 11.5% across the Tasmanian population health areas (PHAs). Three local government areas, corresponding to PHAs, with significant variation in relative change of age-standardised prevalence over the previous decade (-8.3% to 76%), were further examined. The absolute increase in age-standardised CKD prevalence between 2008 and 2023 in Break O’Day (MMM5-6) was 2.7%, higher than Central Coast (2.5%, MMM3-4) and Hobart (1.8%, MMM2). There were high rates of behavioural, psychological, biomedical and environmental risk factors for CKD in this area, most notably a four-fold increase in multimorbidity prevalence compared to the Tasmanian average (Break O’Day 47.5%, Central Coast 18.5%, Hobart 15.6%) together with high rates of active smokers, home wood heaters, financial hardship and decreased access to a General Practitioner.
Conclusion:
The increase in age-standardised prevalence of CKD is matched with a high prevalence of sociodemographic CKD risk factors, suggesting they may contribute to the disproportional regional variation.
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