End‐stage renal disease in the Northern Territory: current and future treatment costs

You, Jiqiong; Hoy, Wendy E.; Zhao, Yuejen; Beaver, C.J.; Eagar, Kathy

doi:10.5694/j.1326-5377.2002.tb04516.x

Cited by 26 publications

(23 citation statements)

References 14 publications

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“…One early task was the description of the rise of ‘RRT’ in all of the remote Aboriginal settings in NT and documentation of its great costs [3, 8, 9]. The application of quantitative tests for proteinuria (superseded by the urinary albumin/creatinine ratio, ACR), and creatinine-based estimates of glomerular filtration rate (eGFR), ushered in studies of the underlying renal disease.…”

Section: Recent Findings and Eventsmentioning

confidence: 99%

Kidney disease in Aboriginal Australians: a perspective from the Northern Territory

Hoy

2014

Clinical Kidney Journal

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This article outlines the increasing awareness, service development and research in renal disease in Aboriginal people in Australia's Northern Territory, among whom the rates of renal replacement therapy (RRT) are among the highest in the world. Kidney failure and RRT dominate the intellectual landscape and consume the most professional energy, but the underlying kidney disease has recently swung into view, with increasing awareness of its connection to other chronic diseases and to health profiles and trajectories more broadly. Albuminuria is the marker of the underlying kidney disease and the best treatment target, and glomerulomegaly and focal glomerulosclerosis are the defining histologic features. Risk factors in its multideterminant genesis reflect nutritional and developmental disadvantage and inflammatory/infectious milieu, while the major putative genetic determinants still elude detection. A culture shift of “chronic disease prevention” has been catalyzed in part by the human pain, logistic problems and great costs associated with RRT. Nowadays chronic disease management is the central focus of indigenous primary care, with defined protocols for integrated testing and management of chronic diseases and with government reimbursed service items and free medicines for people in remote areas. Blood pressure, cardiovascular risk and chronic kidney disease (CKD) are all mitigated by good treatment, which centres on renin-angiotensin system blockade and good metabolic control. RRT incidence rates appear to be stabilizing in remote Aboriginal people, and chronic disease deaths rates are falling. However, the profound levels of disadvantage in many remote settings remain appalling, and there is still much to be done, mostly beyond the direct reach of health services.

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Section: Recent Findings and Eventsmentioning

confidence: 99%

Kidney disease in Aboriginal Australians: a perspective from the Northern Territory

Hoy

2014

Clinical Kidney Journal

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“…While our knowledge of the true economic impact of ARF/RHD remains limited, this is nonetheless extremely good value for money compared with other health interventions in this and other settings. For example, one study in the Northern Territory found that the average annual cost of providing dialysis and other treatment to Aborigines with end‐stage kidney disease was at least $71 000 …”

Section: The Screening Programmentioning

confidence: 99%

Screening for rheumatic heart disease in Aboriginal and Torres Strait Islander children

Rémond

Wark

Maguire

2013

J Paediatrics Child Health

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Rheumatic heart disease is preventable but causes significant morbidity and mortality in Aboriginal Australian and Torres Strait Islander populations. Screening echocardiography has the potential to detect early rheumatic heart disease thereby enabling timely commencement of treatment (secondary prophylaxis) to halt disease progression. However, a number of issues prevent echocardiographic screening for rheumatic heart disease satisfying the Australian criteria for acceptable screening programs. Primarily, it is unclear what criteria should be used to define a positive screening result as questions remain regarding the significance, natural history and potential treatment of early and subclinical rheumatic heart disease. Furthermore, at present the delivery of secondary prophylaxis in Australia remains suboptimal such that the potential benefits of screening would be limited. Finally, the impact of echocardiographic screening for rheumatic heart disease on local health services and the psychosocial health of patients and families are yet to be ascertained.

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“…Transplant rates for Aboriginal people from the NT are 10% lower than the national average. The contributing factors include the low number of indigenous organ donations, distance from the transplanting hospital in Adelaide, and the ability to complete the work‐up for transplant 2 . From January 1997 to December 2001, there were four Aboriginal organ donors in Australia, compared with 927 non‐Aboriginal people 3 .…”

Section: Why Pursue Indigenous Organ Donation?mentioning

confidence: 99%

Exploring pathways to improve indigenous organ donation

Stephens¹

2007

Internal Medicine Journal

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Australia has one of the worst organ donation rates in the western world. The consequence of this is that the waiting list for life-saving transplants is increasing. Australia has a highly successful transplant programme, but a limited number of organs are donated. Unfortunately, Aboriginal people are over-represented in the organ-failure patient group--particularly in end-stage renal disease. Renal transplantation has the potential to improve quantity and quality of life for Aboriginal people with renal failure. Aboriginal people have a right to be given the same opportunities as non-indigenous people to donate their organs at the end of life and improve the transplantation rates among their own people. The most effective way to improve indigenous donation rates will be through improving the knowledge of Aboriginal people about organ donation. There are cultural complexities and end-of-life rituals that make the decision to donate organs difficult, but these issues do not preclude a family from making the decision to donate organs at the end of life. We need to provide Aboriginal communities with appropriately presented information to give them a basis for making an informed decision about organ donation. Equity of access is important. Cultural competence of requestors is important. Consultation, communication and education are the way forward.

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End‐stage renal disease in the Northern Territory: current and future treatment costs

Cited by 26 publications

References 14 publications

Kidney disease in Aboriginal Australians: a perspective from the Northern Territory

Kidney disease in Aboriginal Australians: a perspective from the Northern Territory

Screening for rheumatic heart disease in Aboriginal and Torres Strait Islander children

Exploring pathways to improve indigenous organ donation

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