Dialysis outcomes of elderly indigenous and non-indigenous Australians

Charlotte Mckercher, Hoi Wong Chan, Philip A. Clayton, Stephen Mcdonald, Matthew D. Jose

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5 Citations (Scopus)

Abstract

Aim: Whilst increasing numbers of elderly people in Australia are commencing dialysis, few Indigenous patients are aged ≥65 years and their outcomes are unknown. We compared the long-term survival, mortality hazards and causes of death between elderly Indigenous and elderly non-Indigenous dialysis patients. Methods: This was a retrospective cohort study of adults aged ≥65 years who commenced dialysis in Australia from 2001-2011, identified from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Indigenous (n = 263) and non-Indigenous (n = 10713) patients were followed until death, loss to follow-up, recovery of renal function or 31 December 2011. Mortality was compared using a multivariate Cox proportional-hazards model with age, gender, body mass index, smoking, primary renal disease, comorbidities, late referral and initial treatment modality as predictive variables. Results: Median follow-up was 26.9 months (interquartile range 11.3-48.8 months). Overall 166 Indigenous and 6265 non-Indigenous patients died during the 11-year follow-up period. Mortality rates per 100 patient-years were 23.9 for Indigenous patients and 21.2 for non-Indigenous patients. The overall 1-, 3- and 5-year survival rates were 81%, 49% and 27% for Indigenous patients and 82%, 55% and 35% for non-Indigenous patients respectively. Indigenous patients had a 20% increased risk of mortality compared with non-Indigenous patients (adjusted hazard ratio 1.20, 95% confidence interval, 1.02, 1.41; P = 0.02). 'Social deaths' (predominantly dialysis withdrawal) and cardiac deaths were the main causes of death for both groups. Conclusion: Among elderly dialysis patients in Australia, Indigenous status remains an important factor in predicting survival.

LanguageEnglish
Pages610-616
Number of pages7
JournalNephrology
Volume19
Issue number10
DOIs
Publication statusPublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Dialysis
  • End-stage kidney disease
  • Epidemiology
  • High risk populations

ASJC Scopus subject areas

  • Nephrology

Cite this

Mckercher, C., Chan, H. W., Clayton, P. A., Mcdonald, S., & Jose, M. D. (2014). Dialysis outcomes of elderly indigenous and non-indigenous Australians. Nephrology, 19(10), 610-616. https://doi.org/10.1111/nep.12317