Ethnic differences in the natural progression of nephropathy among diabetes patients in New Zealand: hospital admission rate for renal complications, and incidence of end-stage renal disease and renal death

Abstract

There were huge ethnic disparities in outcomes from renal disease. Screening for early kidney disease among Maori diabetes patients, intensive management of risk factors and further research on the aetiology of renal disease among Maoris is recommended.

Fa’afaletui: A Framework for the Promotion of Renal Health in an Australian Samoan Community

“…In our clinical experience, the Samoan community exhibits a disproportionate rate of kidney and related chronic conditions (such as obesity and diabetes) compared with the general population. This situation is also reported in other parts of Australia (McDonald & Russ, 2003) with large Samoan populations; as well as in New Zealand (Joshy, Dunn, Fisher, & Lawrenson, 2009;Sundhorn et al, 2008;Tomlin, Tilyard, Dawson, & Dovey, 2006) and the United States (Galanis, McGarvey, Quested, Sio, & Afele-Fa'Amuli, 1999;Pearson, 2008). This article demonstrates how a culturally sensitive framework, Fa'afaletui, guided a research project that aimed to increase our understanding of the factors contributing to these issues in one Samoan community in Queensland, Australia, and helped us plan strategies that might ameliorate these issues.…”

Increases in renal replacement therapy in Australia and New Zealand: Understanding trends in diabetic nephropathy

“…The rate of progression of diabetic nephropathy will also affect rates of DN‐related RRT. There are no cohort studies directly comparing rates of disease progression between indigenous and non‐indigenous groups in Australasia; however, observational studies suggest that Māori and Pacific people with diabetes are more likely to develop ESKD than other NZ diabetics 28 . Differences in diabetes care, timing of diabetes diagnosis, 29 glycemic control, smoking 30 and obesity 28 might explain much of the differences in incidence of DN between racial groups in NZ.…”

Incidence of chronic kidney disease among people with diabetes: a systematic review of observational studies

“…The baseline median duration of diabetes varied from 0 to 29 years. Two studies [29,47] recruited study participants at the time of diabetes diagnosis, but 13 studies did not report the baseline duration of diabetes [12,13,27,36,40,50,56,57,71,74,77,78,81]. Characteristics of the 71 included studies are presented in Table S1.…”

“…Several studies reported a higher incidence of ESRD among men than women [25,48,51], but others [47,53,64] reported no significant differences. Incidence of ESRD was higher among African Americans [20,27,29], native people in Canada [77] and Maoris in New Zealand [81] compared with white people (Europids). The hazard of ESRD was also reported higher in Latinos, Chinese, Japanese and Pacific Islanders [20].…”