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Haemodialysis outcomes of Aboriginal and Torres Strait Islander patients of remote Kimberley region origin

Julia V Marley, Hannah K Dent, Maree Wearne, Cherelle Fitzclarence, Carmel Nelson, Karen Siu, Kevin Warr and David Atkinson
Med J Aust 2010; 193 (9): 516-520.

Summary

Objectives: To compare the clinical outcomes and mortality rates of Aboriginal and Torres Strait Islander people of Kimberley origin receiving haemodialysis (HD) treatment with other subsets of Aboriginal and Torres Strait Islander HD patients (Northern Territory, Western Australia excluding the Kimberley region, the rest of Australia) and Australian non-Indigenous HD patients.

Design, participants and setting: Retrospective identification of Aboriginal and Torres Strait Islander patients of Kimberley origin and analysis of secondary data from the Australia and New Zealand Dialysis and Transplant Registry; this group was compared with other Australian patients receiving HD treatment from 1 January 2003 to 31 December 2007.

Main outcome measures: Clinical outcome measures; comorbid conditions; death rates per 100 patient-years, unadjusted and adjusted (for age, sex, comorbid conditions, late referral to nephrologist treatment).

Results: Seventy per cent of HD treatments for Aboriginal and Torres Strait Islander patients of Kimberley origin was provided in the Kimberley. They had comparable adjusted mortality rates to non-Indigenous Australian patients (adjusted mortality rate ratio, 0.80; 95% CI, 0.51–1.23).

Conclusions: This is the first report showing similar mortality rates for Aboriginal and Torres Strait Islander people exclusively from a remote area of Australia and non-Indigenous Australians receiving HD treatment. HD treatment delivered closer to home can be safe and effective in remote areas.

  • Julia V Marley1,2
  • Hannah K Dent3
  • Maree Wearne2
  • Cherelle Fitzclarence2
  • Carmel Nelson2
  • Karen Siu4
  • Kevin Warr4
  • David Atkinson1,2

  • 1 Rural Clinical School of Western Australia, University of Western Australia, Broome, WA.
  • 2 Kimberley Aboriginal Medical Services Council Inc, Broome, WA.
  • 3 Discipline of Public Health, University of Adelaide; Australia and New Zealand Dialysis and Transplant Registry, Adelaide, SA.
  • 4 Department of Renal Medicine, Royal Perth Hospital, Perth, WA.

Correspondence: Julia.Marley@uwa.edu.au

Acknowledgements: 

We thank the staff at Kimberley Satellite Dialysis Centre, Kimberley Aboriginal Health Service and Royal Perth Hospital for providing data for this study.

Competing interests:

We thank the staff at Kimberley Satellite Dialysis Centre, Kimberley Aboriginal Health Service and Royal Perth Hospital for providing data for this study.

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