Acute kidney injury in Indigenous Australians in the Kimberley: age distribution and associated diagnoses

Abstract

Objective To describe the frequencies of acute kidney injury (AKI) and of associated diagnoses in Indigenous people in a remote Western Australian region. Design Retrospective population‐based study of AKI events confirmed by changes in serum creatinine levels. Setting, participants Aboriginal and Torres Strait Islander residents of the Kimberley region of Western Australia, aged 15 years or more and without end‐stage kidney disease, for whom AKI between 1 June 2009 and 30 May 2016 was confirmed by an acute rise in serum creatinine levels. Main outcome measures Age‐specific AKI rates; principal and other diagnoses. Results 324 AKI events in 260 individuals were recorded; the median age of patients was 51.8 years (IQR, 43.9–61.0 years), and 176 events (54%) were in men. The overall AKI rate was 323 events (95% CI, 281–367) per 100 000 population; 92 events (28%) were in people aged 15–44 years. 52% of principal diagnoses were infectious in nature, including pneumonia (12% of events), infections of the skin and subcutaneous tissue (10%), and urinary tract infections (7.7%). 80 events (34%) were detected on or before the date of admission; fewer than one‐third of discharge summaries (61 events, 28%) listed AKI as a primary or other diagnosis. Conclusion The age distribution of AKI events among Indigenous Australians in the Kimberley was skewed to younger groups than in the national data on AKI. Infectious conditions were common in patients, underscoring the significance of environmental determinants of health. Primary care services can play an important role in preventing community‐acquired AKI; applying pathology‐based criteria could improve the detection of AKI.

Remedial role of exercise training to deep‐fried oil‐induced metabolic and histological changes in Wistar rats

“…In our present study, the serum lipid profile of repeatedly deep‐fried vegetable oil consumed rats showed significant hypercholesterolemia compared to raw oil‐fed rats. In acute kidney disease, the glomerular filtration rate is decreased, the concentration of serum creatinine and urea, end product of protein metabolism increases significantly (Higgins, 2016; Mohan, Atkinson, Rosman, & Griffiths, 2019). In the current study, both the concentration of creatinine and urea in the serum of FVO‐fed rats were significantly increased compared to the RVO group although raw oil feeding and exercise training groups have been found as benefitted to lower the creatinine and urea level in the blood (Figure 4).…”

Acute kidney injury in Indigenous Australians: an unrecognised priority for action

“…In this issue of the MJA , Mohan and colleagues report the population burden and diagnoses associated with AKI in Indigenous people in the Kimberley . They identified cases of AKI (defined by Kidney Disease: Improving Global Outcomes [KDIGO] criteria: absolute increase in serum creatinine level in 48 hours of at least 26.5 μmol/L or an increase over 7 days of at least 50%) during 2009–2016 in primary care and hospital electronic record systems.…”