Renal disease

Renal disease, particularly kidney disease, is more prevalent among Indigenous people than among non-Indigenous people [1], but the high rates of end-stage renal disease (ESRD) among Indigenous people have only been fully recognised in recent years.

Extent of renal disease among Indigenous people

Data from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) reveal that a total of 782 Indigenous people were newly identified with ESRD between 2003 and 2006 – the age-standardised notification rate of 782 per 1,000,000 population for Indigenous people was more almost nine times the rate of 97 per 1,000,000 for non-Indigenous people (Table 1) [2] . The highest rates were for Indigenous people living in the NT (2,431 per 1,000,000), WA (1,097), SA (927) and Qld (890).

Table 1 End-stage renal disease: age-standardised notification rates, by Indigenous status, and rate ratios, selected jurisdictions, Australia, 2003-2006

Jurisdiction
Indigenous
Non-Indigenous
Rate ratio
 
Number
Rate
Number
Rate
 
New South Wales
73
284
2,575
95
3.0
Victoria
28
520
1,962
98
5.3
Queensland
208
890
1,557
105
8.5
Western Australia
158
1,097
710
96
11.5
South Australia
52
927
613
94
9.9
Tasmania
3
107
150
75
1.4
Australian Capital
Territory
4
941
179
163
606
Northern Territory
256
2,431
31
86
28.3
Australia
782
837
7,777
97
8.6

Source: Derived from McDonald, Chang & Excell, 2007 [2] and ABS low series population projections

Notes

  1. Rates per 1,000,000 population have been standardised using the Australian population at 31 December 2004 as the reference
  2. Rate ratio is the Indigenous rate divided by the non-Indigenous rate
  3. Figures for Tasmania and the ACT should be interpreted with caution because of the small numbers of notifications

Almost three-fifths (57%) of Indigenous people newly registered with the ANZDATA between 2003-2006 were aged less than 55 years compared with less than one-third (31%) of non-Indigenous people registered (Table 2) [2] .

Apart from the age group 0-14 years, age-specific notification rates were higher for Indigenous people across all ages compared with non-Indigenous people. Rate ratios were particularly high for people aged 35-44 years (9.6), 45-54 years (15.5) and 55-64 years (14.5).

The most common reason for hospitalisation for Indigenous people living in Qld, WA, SA and the NT in 2005-06 was the diagnosis of ‘care involving dialysis’, with the admission rate more than 12 times that of non-Indigenous people [3] .

For the period 1999-2003, death rates from chronic kidney disease (CKD) were up to 10 times higher for Indigenous people than for non-Indigenous people [1] . Death rates were especially high after the age of 25 years for both Indigenous males and females compared with non-Indigenous people. The greatest differences occurred in the 25-34 and 45-54 age groups with Indigenous males recording 38 and 31 times the rates for non-Indigenous males and Indigenous females 57 and 48 times the rates for non-Indigenous females in the same age groups [1] . These figures potentially underestimate the contribution of CKD to death rates as deaths involving CKD can occur in the context of other chronic conditions [4]. For example, deaths from diabetes, where renal failure was reported as an associated cause of death among Indigenous people, occurred at almost twice the rate for Indigenous males and females than for their non-Indigenous counterparts [1] .

Table 2 End-stage renal disease: age-specific notification rates, by Indigenous status, and rate ratios, Australia, 2003-2006

Age (years)
Indigenous
Non-Indigenous
Rate ratio
 
Number
Rate
Number
Rate
 
0-14
4
5
89
6
0.9
15-24
12
31
185
17
1.8
25-34
48
164
393
35
4.7
35-44
140
573
705
60
9.6
45-54
244
1504
1059
97
15.5
55-64
226
2659
1557
183
14.5
65-74
89
2333
2059
374
6.2
75+
19
1196
1730
347
3.4
All ages
782
 
7777
 
 

Source: Derived from McDonald, Chang & Excell, 2007 [2] and ABS low series population projections

Notes

  1. Rates per 1,000,000 population
  2. Rate ratio is the Indigenous rate divided by the non-Indigenous rate

References

1 Australian Bureau of Statistics, Australian Institute of Health and Welfare (2005) The health and welfare of Australia's Aboriginal and Torres Strait Islander peoples 2005. (ABS catalogue no. 4704.0) Canberra: Australian Institute of Health and Welfare and the Australian Bureau of Statistics

2 McDonald S, Chang S, Excell L, eds.(2007) Australia and New Zealand Dialysis and Transplant Registry: the thirtieth report. Adelaide: Australia and New Zealand Dialysis and Transplant Registry

3 Australian Institute of Health and Welfare (2007) Australian hospital statistics 2005-06. (AIHW catalogue no. HSE 50) Canberra: Australian Institute of Health and Welfare

4 Kidney Health Australia (2006) National chronic kidney disease strategy, draft January 2006. Melbourne: Kidney Health Australia

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Last updated: 15 April 2008