The burden of kidney disease in Indigenous children of Australia and New Zealand, epidemiology, antecedent factors and progression to chronic kidney disease

Authors

  • Andrew White,

    Corresponding author
    1. James Cook University, Townsville
    2. The Townsville Hospital, Townsville, Queensland, Australia
      Dr Andrew White, JCU Clinical School, The Townsville Hospital, 100 Angus Smith Drive, Douglas QLD 4814, Australia. Fax: +617 47961401; email: andrew.white@jcu.edu.au
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  • William Wong,

    1. Starship Children's Hospital, Auckland, New Zealand
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  • Premala Sureshkumur,

    1. Centre for Kidney Research, NHMRC Centre for Clinical Research Excellence, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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  • Gurmeet Singh

    1. Child Health, Menzies School of Health Research, Darwin, Northern Territory, Australia
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Dr Andrew White, JCU Clinical School, The Townsville Hospital, 100 Angus Smith Drive, Douglas QLD 4814, Australia. Fax: +617 47961401; email: andrew.white@jcu.edu.au

Abstract

Aims:  To review and present the most important issues related to kidney disease in Aboriginal, Torres Strait Islander, Maori and Pacific Islander children from Australia and New Zealand.

Methods:  A review of medical literature about: 1. incidence of kidney disease in Indigenous children in Australia and New Zealand, especially where rates are different from the general populations, 2. factors in early life which increase risk for chronic kidney disease in adult life, and 3. early identification and primary and secondary interventions in childhood which may prevent chronic kidney disease in adults.

Results:  Kidney diseases, both acute and chronic are more common in Maori, Pacific Islander, Australian Aboriginal and Torres Strait Islander people. The reasons are multiple and include genetic, environmental and socio-economic factors. In childhood post streptococcal glomerulonephritis, haemolytic uraemic syndrome, renal stones and acute kidney injury all occur at higher frequency in at least some of the Indigenous populations. Chronic kidney disease CKD occurs more commonly, and at a younger age in Indigenous than non Indigenous people. Factors involved may include reduced nephron endowment at birth, and subsequent insults including nephritis, obesity, and early onset type 2 diabetes, as well as underlying socioeconomic and environmental determinants.

Conclusion:  A lifecourse understanding allows one to conceptualise multiple risk factors and target interventions.

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