Factors Contributing To Chronic Kidney Disease Among Indigenous Australians

Prevalence of Chronic Kidney Disease among Indigenous Australians

Kidney diseases are one of the most important health problems that affect a large number of Australians. However a greater number of individuals who are found to be affected by chronic kidney disorder mainly belong to the indigenous backgrounds in Australia than the non indigenous backgrounds. It has been found that almost about 10% of the new cases of the treated end stage kidney diseases called the ESKD were found to be belonging to indigenous backgrounds where only 2.5% of the Australians comprises of indigenous Australians, therefore form this estimation, one can easily assume the extend of the population of the aboriginals and Torres islanders who are getting affected by the disorders. In the year 2008-2009, the rate of hospitalization for conducting of dialysis for such patients of the indigenous background were found to be 11 times gathering than that of the non indigenous people (Hoy et al., 2014).

Different types of information regarding the details of chronic kidney disease among the population of the indigenous Australians are mainly obtained from self reported surveys as well as form different community based studies and different types of screening programs (Ashman et al., 2016). The rates have been found to be higher among the indigenous people who live in remote areas and very remote areas with the highest being in the northern Australian communities. Mostly, the hospitalization increases mainly due to the increased urgency of the kidney replacement therapy for the ESKD cases of the indigenous people. However due to high cost of the therapy, regular dialysis system is also conducted that has also a higher number of admission to hospitals. Deaths due to kidney disorders are more common in indigenous that non indigenous population of Australia. The death ratio is particularly higher after the age of 25 years for both males and females of the indigenous backgrounds (Foote et al., 2014).

The different factors that have been found by researchers to be the main factors that lead to the development of the disorders in the population of the aboriginals and the Torres islander includes improper maintenance of the symptoms of diabetes, glomerulo-nephrititis and hypertension. Moreover abnormal lipid metabolism, mineral and bone disorders, sleep apnoea, anemia, dietary protein restriction, acidosis, restless legs and depression.  Other associated function s resulting to impaired kidney functions involves poor nutrition, proteinuria, uraemia, hyperkalemis and others (Jha et al., 2014). Moreover, many researchers ate of the opinion that the increasing incidences of chronic disorders are mainly due to the modification so their once active lifestyles as well as roles which was the main result of the displacement and colonization conducted by the Europeans.. This had been suggested by them to have been embedded in the various social foundations and is automatically reflected as the social determinants of health. This had been the contributor of the development of critical kidney diseases along with others.

Social and economic factors that also contribute to the higher number of kidney diseases include different health care systems as well as the policies which have failed to provide proper access to primary and medical care. Moreover substandard living conditions, poverty as well as inadequate environmental sanitation are also resulting in increases in patients with CKD. It is extremely important for the concerned authorities of not only paying importance to prevention, control and also management of kidney diseases but also ponder upon effective as well as acceptable treatment and preventive action which will inevitably address different poor socioeconomic conditions. Besides, these different behavioral as well as biomedical factors are also responsible for the occurrence of the disorders. This includes reported infections, low birth weight, infant malnutrition and others (Tsai et al., 2016). Moreover engagement in high risk behaviors also results in ill effects. These behaviors include poor diet, alcohol and tobacco use and also low activity levels. These are more common in indigenous women and hence researchers suggest that efforts to minimize the risks will bring done positive effects in reduction of the kidney disorders among indigenous populations.

Factors Contributing to Chronic Kidney Disease among Indigenous Australians

A number of initiative should been taken on the governmental levels in order to address the health issues of the indigenous Australians regarding the kidney disorders. KIDNEY HEALTH FOR ALL was a report on the policy options that mainly aimed to improve the conditions of the aboriginal as well as the Torres Strait Islanders who are suffering from kidney disorders. This initiative to close the gap experienced by the indigenous while accessing healthcare, was informed by the Kidney Health Australia’s World Kidney Day Leadership Breakfast and Policy Roundtable (Garcia et al., 2015). It actually had helped to provide an overview of the different types of issues that are faced by the indigenous people who are suffering from kidney disorder. This policy has helped by making new recommendations which are needed to be considered by the Federal Government, state as well as the Territory governments. They also helped in guiding the key health organizations working for betterment of health  for the indigenous people and the kidney community. This was published in the year 2015 in the month of the September. The Senate Select committee on Health was founded in the year 2014 so that they can inquire on the health policy as well as the administration and expenditure of the initiatives that are taken for the indigenous people. When they called for submissions with particular reference of the indigenous health, KHA came forward with a number of guidelines that helped to contribute to the noble cause. The indigenous people’s experiences disproportionate levels of CKD treatments regardless of their urban, regional as well as their rural locality were discussed. They also discussed about the scope of the Federal Government in providing solid leadership in different indigenous affairs and health with the association of the department of the Prime minister and cabinet (DPMC) and also in proper policy implementation. Moreover importance of the competent as well as qualified, culturally respectful and multidisciplinary health workforce is also discussed to be significant in improvement of the aboriginals as well as the Torres strait Islander health.. these policies have also helped to address the issues of locational services by introducing a wide varieties of support services for the clients and also their families who remain in need to be accessible and also better integrated so that they can also limit the severity of dislocation for treatments (Luckett et al., 2017). The policies have also stated that adequately resourced preventive programs in the primary health sector reduce the progression of the various types of chronic diseases like the kidney diseases. This will in turn lead to longer term savings in the later stage acute as well as high cost interventions.

Hence, one can see that although the government is trying their best to close the gap of the health benefits received by the non indigenous as well as indigenous people, high numbers of affected individuals are still seen. A number of socioeconomic factors still act as determinants of health which need to be discussed by the concerned authorities. A number of policies are newly introduced in the nation that had helped to cover many important aspects needed to bridge the gap of inequality in health treatment. It can be assured that the equity of healthcare treatment for all the Australians (both indigenous and non indigenous) suffering from chronic kidney diseases can be achieved within a few years making a nation with generations full of promises for better quality living.

References:

Ashman, A. M., Collins, C. E., Weatherall, L., Brown, L. J., Rollo, M. E., Clausen, D., … & Lumbers, E. R. (2016). A cohort of Indigenous Australian women and their children through pregnancy and beyond: the Gomeroi gaaynggal study. Journal of developmental origins of health and disease, 7(4), 357-368.

Foote, C., Clayton, P. A., Johnson, D. W., Jardine, M., Snelling, P., & Cass, A. (2014). Impact of estimated GFR reporting on late referral rates and practice patterns for end-stage kidney disease patients: a multilevel logistic regression analysis using the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). American Journal of Kidney Diseases, 64(3), 359-366.

Garcia-Garcia, G., Jha, V., Tao Li, P. K., Garcia-Garcia, G., Couser, W. G., Erk, T., … & Osafo, C. (2014). Chronic kidney disease (CKD) in disadvantaged populations. Clinical kidney journal, 8(1), 3-6.

Hoy, W. E., White, A. V., Tipiloura, B., Singh, G. R., Sharma, S., Bloomfield, H., … & McCredie, D. A. (2014). The influence of birthweight, past poststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults: the multideterminant model of renal disease in a remote Australian Aboriginal population with high rates of renal disease and renal failure. Nephrology Dialysis Transplantation, 31(6), 971-977.

Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., … & Yang, C. W. (2013). Chronic kidney disease: global dimension and perspectives. The Lancet, 382(9888), 260-272.

Luckett, T., Spencer, L., Morton, R. L., Pollock, C. A., Lam, L., Silvester, W., … & Clayton, J. M. (2017). Advance care planning in chronic kidney disease: a survey of current practice in Australia. Nephrology, 22(2), 139-149.

Maple-Brown, L. J., Hughes, J. T., Ritte, R., Barzi, F., Hoy, W. E., Lawton, P. D., … & Cherian, S. (2016). Progression of kidney disease in Indigenous Australians: The eGFR follow-up study. Clinical Journal of the American Society of Nephrology, CJN-09770915.

Sellars, M., Tong, A., Luckett, T., Morton, R. L., Pollock, C. A., Spencer, L., … & Clayton, J. M. (2017). Clinicians’ Perspectives on Advance Care Planning for Patients With CKD in Australia: An Interview Study. American Journal of Kidney Diseases.