Renal disease in the Aboriginal community of Woorabinda

Abstract

An apparent increase in the incidence of end-stage renal disease had been observed in the Australian Aboriginal community of Woorabinda. This study documents the incidence of end-stage renal disease (ESRD) in Woorabinda, and correlates this with predictors of renal disease. The methodology included a retrospective audit of deaths from, and cases commencing treatment for ESRD between 1999 and 2001 in Woorabinda, and a cross-sectional study. The 183 participants were Aboriginal residents over 15 years of age. Females numbered 102 (55.7%) and males 81 (44.3%). The incidence of ESRD was comparable to other recognised high incidence Indigenous communities in Australia. This was corroborated by a high prevalence of predictors of renal disease. Audit: the year 2001 age- and sex-standardised incidence ratio for commencement of renal replacement therapy is 93.18 (95% CI, 25.34-238.53). Clinical Study: the prevalence of overt albuminuria was 7.6%; 11.7% had an albumin : creatinine ratio >3.4-33.9 g mol(-1); 33.3% had microalbuminuria of > or =20 mg L(-1); and 67.8% prevalence of proteinuria was found. The prevalence of diabetes was 18.6%, with another 13.2% having impaired fasting glucose. There was a 19.7% prevalence of hypertension. Of those with hypertension 22.2% had overt albuminuria. Although Woorabinda was previously placed in a region of low end-stage renal disease incidence, further investigation has identified a high incidence of renal disease, not exclusively due to diabetes. The finding raises questions regarding the current trajectory of the epidemic in other Aboriginal and Torres Strait Islander communities.