Document Detail

Deprivation and dialysis: pathways to kidney failure in Australian Aborigines.
MedLine Citation:
PMID:  15719338     Owner:  NLM     Status:  MEDLINE    
Rates of end-stage renal disease among Australian Aboriginal people have been increasing over the past 2 decades, particularly in the northern and more remote areas of Australia, and especially in disadvantaged communities. Proteinuria predicts the rate of loss of kidney function; it is common in young adults and virtually universal in those over 50 years of age. Cumulative independent risk factors include low birth weight, recurrent skin infections, adult obesity, diabetes or its precursors, smoking, excessive alcohol intake, and a family history of renal disease. A plausible theory is that intrauterine malnutrition permanently reduces total nephron numbers, which are then overworked in adulthood by the metabolic stresses of obesity (from excess alcohol and poor diet), by higher blood pressures, and by infections, while starved of blood supply because of smoking. Although kidney disease is often only detected when already well established, active medical intervention offers great rewards. Control of blood pressure (preferentially using angiotensin-converting enzyme (ACE) inhibitors and angiotensin-II receptor blockers (AIIRBs) in combination) can often stop or even reverse kidney damage, even if ongoing diabetes control is poor. Adequately funded kidney health programs with active Aboriginal health worker involvement are enormously cost-effective: tight blood pressure control at least halves the rate of disease progression, and every year of dialysis deferred for 1 patient could fund the appointment of 2 health workers. Addressing the underlying social causes for this epidemic is critical.
Mark Thomas
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Advances in chronic kidney disease     Volume:  12     ISSN:  1548-5595     ISO Abbreviation:  -     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-02-18     Completed Date:  2005-06-28     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  101209214     Medline TA:  Adv Chronic Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  84-7     Citation Subset:  IM    
Department of Nephrology, Royal Perth Hospital, Perth, Western Australia 6001, Australia.
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MeSH Terms
Australia / epidemiology
Disease Progression
Kidney Failure, Chronic / ethnology*,  therapy
Oceanic Ancestry Group*
Risk Factors
Rural Population

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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