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Accurate Assessment of Kidney Function in Indigenous Australians: The Estimated GFR Study

Published:August 13, 2012DOI:https://doi.org/10.1053/j.ajkd.2012.07.001
      The incidence of end-stage renal disease (ESRD) is up to 15 times higher in Indigenous than nonindigenous Australians,

      Australian Institute of Health and Welfare (AIHW) 2004. Heart, stroke and vascular diseases—Australian facts 2004. AIHW Cat. No. CVD 27. Canberra: AIHW and National Heart Foundation of Australia (Cardiovascular Disease Series No. 22).

      • Preston-Thomas A.
      • Cass A.
      • O'Rourke P.
      Trends in the incidence of treated end-stage kidney disease among indigenous Australians and access to treatment.
      with the burden of ESRD in Indigenous Australians borne disproportionately by those in central and northern Australia.
      • Cass A.
      • Cunningham J.
      • Wang Z.
      • Hoy W.
      Regional variation in the incidence of end-stage renal disease in indigenous Australians.
      This group of people is broadly dispersed and heterogeneous, with wide variation in diet, body habitus, ethnic admixture, and socioeconomic background.
      • Piers L.S.
      • Rowley K.G.
      • Soares M.J.
      • O'Dea K.
      Relation of adiposity and body fat distribution to body mass index in Australians of Aboriginal and European ancestry.
      • Cass A.
      • Cunningham J.
      • Snelling P.
      • Wang Z.
      • Hoy W.
      End-stage renal disease in indigenous Australians: a disease of disadvantage.
      Indigenous Australians traditionally had a “linear” body build (narrow shoulders and hips, relatively long limbs, and short torso), which, unlike African Americans, is associated with proportionately less muscle and more fat for a given weight.
      • Piers L.S.
      • Rowley K.G.
      • Soares M.J.
      • O'Dea K.
      Relation of adiposity and body fat distribution to body mass index in Australians of Aboriginal and European ancestry.
      • Rutishauser I.H.
      • McKay H.
      Anthropometric status and body composition in aboriginal women of the Kimberley region.
      We hypothesized that the African American correction factor in estimated glomerular filtration rate (eGFR) equations should not be used in Indigenous Australians and that differences in body build and body composition in Indigenous Australians would affect the utility of creatinine-based eGFRs. The aim of this study was to validate and improve if necessary the accuracy and precision of eGFR equations in Indigenous Australians.
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