Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data

Introduction: Peritoneal dialysis (PD) enables people to use kidney replacement therapy (KRT) outside of healthcare-dependent settings, a strong priority of Aboriginal and Torres Strait Islander people. Methods: We undertook an observational study analyzing registry data to describe access to PD and...

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Main Authors: Ashik Hayat, Yeoungjee Cho, E.M. Pascoe, Rathika Krishnasamy, Monique Borlace, Jenny Chen, Neil Boudville, Kamal Sud, M. Varnfield, Ross Francis, Rochelle Pitt, Jaquelyne T. Hughes, David Wayne Johnson
Format: Article
Language:English
Published: Elsevier 2024-05-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924000718
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author Ashik Hayat
Yeoungjee Cho
E.M. Pascoe
Rathika Krishnasamy
Monique Borlace
Jenny Chen
Neil Boudville
Kamal Sud
M. Varnfield
Ross Francis
Rochelle Pitt
Jaquelyne T. Hughes
David Wayne Johnson
author_facet Ashik Hayat
Yeoungjee Cho
E.M. Pascoe
Rathika Krishnasamy
Monique Borlace
Jenny Chen
Neil Boudville
Kamal Sud
M. Varnfield
Ross Francis
Rochelle Pitt
Jaquelyne T. Hughes
David Wayne Johnson
author_sort Ashik Hayat
collection DOAJ
description Introduction: Peritoneal dialysis (PD) enables people to use kidney replacement therapy (KRT) outside of healthcare-dependent settings, a strong priority of Aboriginal and Torres Strait Islander people. Methods: We undertook an observational study analyzing registry data to describe access to PD and its outcome as the first KRT among Aboriginal and Torres Strait Islander people between January 1, 2004 and December 31 2020. Results: Out of 4604 Aboriginal and Torres Strait Islander people, reflecting 10.4% of all Australians commencing KRT, PD was the first KRT modality among 665 (14.4%). PD utilization was 17.2% in 2004 to 2009 and 12.7% in 2016 to 2020 (P = 0.002); 1105 episodes of peritonitis were observed in 413 individuals, median of 3 (interquartile range [IQR], 2–5) episodes/patient. The crude peritonitis rate was 0.53 (95% confidence interval [CI], 0.50–0.56) episodes/patient-years without any significant changes over time. The median time to first peritonitis was 1.1 years. A decrease in the peritonitis incidence rate ratio (IRR) was observed in 2016 to 2020 (IRR, 0.63 [95% CI, 0.52–0.77], P < 0.001) compared to earlier eras (2010–2015: IRR, 0.90 [95% CI, 0.76–1.07], P = 0.23; Ref: 2004–2009). The cure rates decreased from 80.0% (n = 435) in 2004 to 2009, to 70.8% (n = 131) in 2016 to 2020 (P < 0.001). Conclusion: Aboriginal and Torres Strait Islander people who utilized PD as their first KRT during 2004 to 2020 recorded a higher peritonitis rate than the current benchmark of 0.4 episodes/patient-years. The cure rates have worsened recently, which should be a big concern. There is an exigent need to address these gaps in kidney care for Aboriginal and Torres Strait Islander people.
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spelling doaj-art-2a117fbc16064bb4a601929ab7ff02fd2025-08-20T02:06:04ZengElsevierKidney International Reports2468-02492024-05-01951484149510.1016/j.ekir.2024.01.059Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry DataAshik Hayat0Yeoungjee Cho1E.M. Pascoe2Rathika Krishnasamy3Monique Borlace4Jenny Chen5Neil Boudville6Kamal Sud7M. Varnfield8Ross Francis9Rochelle Pitt10Jaquelyne T. Hughes11David Wayne Johnson12Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, AustraliaAustralasian Kidney Trials Network, The University of Queensland, Brisbane, AustraliaAustralasian Kidney Trials Network, The University of Queensland, Brisbane, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitAustralasian Kidney Trials Network, The University of Queensland, Brisbane, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, AustraliaDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Sunshine Coast University Hospital, Queensland, Australia; Department of Nephrology, Royal Adelaide Hospital, Adelaide, Australia; Department of Renal Medicine, Wollongong Hospital, Wollongong, Australia; School of Medicine, University of Wollongong, Wollongong, Australia; Medical School, University of Western Australia, Perth, Australia; Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia; Nepean KIdney Research Centre, Department of Renal Medicine, Nepean Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Australian e-Health Research Centre; CSIRO, Brisbane, Australia; Inala Indigenous Health Services, Queensland, Australia; Royal Darwin Hospital, Northern Territory, Darwin, Australia; Rural and Remote Health, College of Medicine and Public Health, Flinders University Northern Territory, Nhulunbuy, Australia; Wagadagam tribe of near west Torres StraitDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia; Translational Research Institute, Brisbane, Australia; Correspondence: David Wayne Johnson, Department of Nephrology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland 4102, Australia.Introduction: Peritoneal dialysis (PD) enables people to use kidney replacement therapy (KRT) outside of healthcare-dependent settings, a strong priority of Aboriginal and Torres Strait Islander people. Methods: We undertook an observational study analyzing registry data to describe access to PD and its outcome as the first KRT among Aboriginal and Torres Strait Islander people between January 1, 2004 and December 31 2020. Results: Out of 4604 Aboriginal and Torres Strait Islander people, reflecting 10.4% of all Australians commencing KRT, PD was the first KRT modality among 665 (14.4%). PD utilization was 17.2% in 2004 to 2009 and 12.7% in 2016 to 2020 (P = 0.002); 1105 episodes of peritonitis were observed in 413 individuals, median of 3 (interquartile range [IQR], 2–5) episodes/patient. The crude peritonitis rate was 0.53 (95% confidence interval [CI], 0.50–0.56) episodes/patient-years without any significant changes over time. The median time to first peritonitis was 1.1 years. A decrease in the peritonitis incidence rate ratio (IRR) was observed in 2016 to 2020 (IRR, 0.63 [95% CI, 0.52–0.77], P < 0.001) compared to earlier eras (2010–2015: IRR, 0.90 [95% CI, 0.76–1.07], P = 0.23; Ref: 2004–2009). The cure rates decreased from 80.0% (n = 435) in 2004 to 2009, to 70.8% (n = 131) in 2016 to 2020 (P < 0.001). Conclusion: Aboriginal and Torres Strait Islander people who utilized PD as their first KRT during 2004 to 2020 recorded a higher peritonitis rate than the current benchmark of 0.4 episodes/patient-years. The cure rates have worsened recently, which should be a big concern. There is an exigent need to address these gaps in kidney care for Aboriginal and Torres Strait Islander people.http://www.sciencedirect.com/science/article/pii/S2468024924000718Aboriginal and Torres Strait Islander peopleassociationsoutcomesperitoneal dialysisperitonitisrisk-factors
spellingShingle Ashik Hayat
Yeoungjee Cho
E.M. Pascoe
Rathika Krishnasamy
Monique Borlace
Jenny Chen
Neil Boudville
Kamal Sud
M. Varnfield
Ross Francis
Rochelle Pitt
Jaquelyne T. Hughes
David Wayne Johnson
Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
Kidney International Reports
Aboriginal and Torres Strait Islander people
associations
outcomes
peritoneal dialysis
peritonitis
risk-factors
title Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
title_full Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
title_fullStr Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
title_full_unstemmed Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
title_short Uptake and Outcomes of Peritoneal Dialysis among Aboriginal and Torres Strait Islander People: Analysis of Registry Data
title_sort uptake and outcomes of peritoneal dialysis among aboriginal and torres strait islander people analysis of registry data
topic Aboriginal and Torres Strait Islander people
associations
outcomes
peritoneal dialysis
peritonitis
risk-factors
url http://www.sciencedirect.com/science/article/pii/S2468024924000718
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