Rising Incidence of End-Stage Kidney Disease and Poorer Access to Kidney Transplant Among Australian Aboriginal and Torres Strait Islander Children and Young Adults

作者：Swasti Chaturvedi, Shahid Ullah, Amelia K. LePage, Jaquelyne T. Hughes · 发表于：Kidney International Reports · 年份：2021 · DOI：10.1016/j.ekir.2021.02.040 · 被引用次数：19 · 研究领域：Renal Transplantation Outcomes and Treatments、Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes

Introduction Details of the pediatric population with end-stage kidney disease (ESKD) in Australia and New Zealand have been published previously. There is, however, a paucity of studies exploring the trends in incidence, etiology, renal replacement therapy (RRT) modality, and transplant access among the Aboriginal and Torres Strait Islander children and young adults (ATCYAs) residing in Australia. Methods An observational study was undertaken and data on Australian patients who commenced RRT at ≤24 years of age between 1963 and 2017 were extracted from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA). The incidence and prevalence rates were restricted from 1997 to 2017 because of the unavailability of Aboriginal– and Torres Strait Islander status–specific census data before 1997. Results A total of 3629 children and young adults received RRT during the observation period, including 178 (4.9%) who identified as ATCYAs and 3451 (95.1%) other children and young adults (OCYAs). Compared with OCYAs, incident rates have risen among ATCYAs since 2000, with the biggest rise for young adults 20 to 24 years of age. Fewer ATCYAs received a kidney transplant compared with OCYAs (56.2% vs. 89.3%, P < 0.001). Pre-emptive kidney transplants were less common in ATCYAs compared with OCYAs (3.4% vs. 16.8%, P < 0.001). Living related donor transplants were less common among ATCYAs than OCYAs (10.7% vs. 35.9%, P < 0.001). Conclusions Our study shows rising incident rate...