Nephrol Dial Transplant (2004) 19: 678-685
Nephrol Dial Transplant Vol. 19 No. 3 (c) ERA-EDTA 2004; all rights reserved
Original Article
The incidence of treated end-stage renal disease in New Zealand Maori and Pacific Island people and in Indigenous Australians
1Department of Renal Medicine, Westmead Hospital, Westmead, NSW, Australia, 2Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand and 3Australia and New Zealand Dialysis and Transplant Registry, Queen Elizabeth Hospital, Woodville, SA, Australia
Correspondence and offprint requests to: Dr Margaret McCredie, Department of Preventive and Social Medicine, University of Otago, PO Box 913, Dunedin, New Zealand. Email: margaret.mccredie{at}stonebow.otago.ac.nz
Background. Although Indigenous Australians, New Zealand Maori and Pacific Island people comprise an unduly high proportion of patients treated for end-stage renal disease (ESRD) in the two countries, no population-based age- and disease-specific rates have been published.
Methods. From data provided to the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), truncated age- and sex-standardized incidence rates were calculated for treated ESRD due to all causes and by primary renal disease, in four broad age groups of Maori, Pacific Island people and all ‘other’ New Zealanders and Indigenous and non-indigenous Australians, for the period 1992–2001.
Results. The incidence of ESRD did not differ in persons aged 0–14 years. In adults, Maori and Pacific Island people had similar rates of ESRD, a little more than half those of Indigenous Australians except in persons aged 65 years and over in whom the rates were nearly equal, but two to ten times the rates in ‘other’ New Zealanders and non-indigenous Australians. The excess of ESRD in Indigenous Australians was due principally to type II diabetic nephropathy and glomerulonephritis (all common types except lupus nephritis), but was seen also in respect of type I diabetic nephropathy, hypertensive renal disease and analgesic nephropathy, while the excess in Maori and Pacific Island people was confined to type II diabetic nephropathy, hypertensive renal disease and glomerulonephritis (especially lupus nephritis and type I mesangiocapillary glomerulonephritis, but not mesangial IgA disease).
Conclusions. The incidence and pattern of treated ESRD differs quantitatively and qualitatively between Maori, Pacific Island people and other New Zealanders, and Indigenous and non-indigenous Australians.
Keywords: end-stage renal disease; glomerulonephritis; incidence; Indigenous Australians; New Zealand Maori; Pacific Island people