Kidney Week

Abstract: TH-PO723

Addressing Disparities in Kidney Health Outcomes for First Nations Peoples of the United States, Canada, Australia, and New Zealand: A Systematic Review

Session Information

• Diversity and Equity in Kidney Health - I
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 800 Diversity and Equity in Kidney Health

Authors

• Riceman, Michael D., The University of Adelaide, Adelaide, South Australia, Australia

Michael D. Riceman,

• Bateman, Samantha, The University of Adelaide, Adelaide, South Australia, Australia

Samantha Bateman,

• Tunnicliffe, David J., University of Sydney, Sydney, New South Wales, Australia

David J. Tunnicliffe,

• Lester, Rhanee, The University of Adelaide, Adelaide, South Australia, Australia

Rhanee Lester,

• Sinclair, Nari, The University of Adelaide, Adelaide, South Australia, Australia

Nari Sinclair,

• Owen, Kelli, The University of Adelaide, Adelaide, South Australia, Australia

Kelli Owen,

• Howell, Martin, University of Sydney, Sydney, New South Wales, Australia

Martin Howell,

• Pearson, Odette Rachel, The University of Adelaide, Adelaide, South Australia, Australia

Odette Rachel Pearson,

• McDonald, Stephen P., The University of Adelaide, Adelaide, South Australia, Australia

Stephen P. McDonald,

• Jesudason, Shilpa, The University of Adelaide, Adelaide, South Australia, Australia

Shilpa Jesudason,

Background

First Nations Peoples of colonised counties are disproportionately burdened with kidney failure. Current systems of kidney care are failing to meet their needs, despite strong advocacy from community. We aimed to identify how disparities in health outcomes for First Nations Peoples of colonial countries living with kidney failure are addressed through different models of care.

Methods

We conducted a systematic review according to the PRISMA Checklist, governed by a First Nations reference group. Included studies involved First Nations Peoples of the USA, Canada, New Zealand and Australia and interventions to address the management or complications of kidney failure. The certainty of the evidence was assessed using GRADE.

Results

We identified 31 studies across 5 domains: dialysis care, dialysis access (vascular/peritoneal), transplantation, kidney failure complications, nutrition, and cultural safety. Few First Nations-specific randomised trials were identified. The largest body of evidence came from Australia and related to community-based dialysis care. From the Americas there is a moderate level of evidence for co-created, community-based living kidney donor transplant education and awareness campaigns.

Conclusion

Within the limited literature, there is evidence that purposeful, First Nations-led interventions can have positive impacts. However, considering the inequities faced by First Nations Peoples of colonial countries there is an unacceptable paucity of intervention studies evaluating First Nations specific models of kidney care.

Figure 1: Adapted PRISMA diagram of study selection

Figure 2: Data analysis schema

Funding

• Government Support – Non-U.S.