Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria

Samuel, Susan; Palacios-Derflingher, Luz; Tonelli, Marcello; Manns, Braden; Crowshoe, Lynden; Ahmed, Sofia B.; Jun, Min; Saad, Nathalie; Hemmelgarn, Brenda R.

doi:10.1503/cmaj.130776

Cited by 51 publications

(33 citation statements)

References 26 publications

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“…Similar to the findings by Chang et al among U.S. racial/ethnic groups [29*], this difference was not explained by the greater prevalence of albuminuria among the First Nations participants, and albuminuria conferred a similar risk of progression to kidney failure for First Nations and Non–First Nations people [32]. Potential explanations for this disparity offered by the authors, and opportunities for intervention, include First Nations people’s documented receipt of lower quality health care and limited access to specialist care.…”

Section: Contribution Of Non-genetic Factors To Disparities In Ckd Prsupporting

confidence: 85%

Disparities in the burden, outcomes, and care of chronic kidney disease

Crews

Liu

Boulware

2014

Current Opinion in Nephrology and Hypertension

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Purpose of review Racial/ethnic and socioeconomic disparities in chronic kidney disease (CKD) have been documented for decades, yet little progress has been made in mitigating them. Several recent studies offer new insights into the root causes of these disparities, point to areas where future research is warranted and identify opportunities for changes in policy and clinical practice. Recent findings Recently published evidence suggests that geographic disparities in CKD prevalence exist and vary by race. CKD progression is more rapid for racial/ethnic minority groups as compared to whites and may be largely, but not completely, explained by genetic factors. Stark socioeconomic disparities in outcomes for dialysis patients exist, and vary by race, place of residence and treatment facility. Disparities in access to living kidney donation may be driven primarily by the socioeconomic status of the donor as opposed to recipient factors. Summary Recent studies highlight opportunities to eliminate disparities in CKD, including efforts to direct resources to areas and populations where disparities are most prevalent, efforts to understand how to best use emerging information on the contribution of genetic factors to disparities, and continued work to identify modifiable environmental, social, and behavioral factors for targeted interventions among high-risk populations.

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Section: Contribution Of Non-genetic Factors To Disparities In Ckd Prsupporting

confidence: 85%

Disparities in the burden, outcomes, and care of chronic kidney disease

Crews

Liu

Boulware

2014

Current Opinion in Nephrology and Hypertension

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“…For example, in contrast to Australia, New Zealand, and the United States, the literature regarding the impacts of Indigenous/non-Indigenous misclassification on Indigenous health assessment is almost nonexistent in Canada. In Indigenous health publications and reports drawing on data linkages with Indigenous registries, limitations such as the restriction of the Indigenous population to First Nations persons with status or registered Métis are commonly given only superficial mention near the end of the article, with little discussion of the potential impacts, if at all [75][76][77]119]. The NHS Aboriginal statistics releases and accompanying technical reports do not transparently identify the loss of Indigenous statistics released at the smaller regional level, despite the fact that this will have huge negative impacts on Indigenous health service planning and delivery.…”

Section: Under-reporting Of Methodologic Limitations and Their Conseqmentioning

confidence: 99%

“…While it is standard practice for researchers involved in primary data collection and analysis with Indigenous communities in Canada to describe the specifics of Indigenous community engagement and participation in the research study within their scholarly publications, this information is typically excluded from publications involving secondary data analysis. For example, the three most recent research publications on Indigenous health published in Canada's highest impact health journal, the Canadian Medical Association Journal (CMAJ) were population based epidemiologic analyses of Indigenous/non-Indigenous disparities in the management of acute myocardial infarction, risk of progression to end-stage re- nal disease and death among diabetics, and progression to kidney failure according to presence and severity of albuminuria respectively [75][76][77]. All three studies relied on secondary data analysis involving a crosslinkage between federal Indian registration records as defined by the Indian Act with provincial health databases to identity the Indigenous cohort.…”

Section: Aboriginal Idenɵty Populaɵon In Canada 2011 Nhsmentioning

confidence: 99%

Back to the basics: Identifying and addressing underlying challenges in achieving high quality and relevant health statistics for Indigenous populations in Canada

Smylie

Firestone

2015

Statistical Journal of the IAOS

112

103

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Canada is known internationally for excellence in both the quality and public policy relevance of its health and social statistics. There is a double standard however with respect to the relevance and quality of statistics for Indigenous populations in Canada. Indigenous specific health and social statistics gathering is informed by unique ethical, rights-based, policy and practice imperatives regarding the need for Indigenous participation and leadership in Indigenous data processes throughout the spectrum of indicator development, data collection, management, analysis and use. We demonstrate how current Indigenous data quality challenges including misclassification errors and non-response bias systematically contribute to a significant underestimate of inequities in health determinants, health status, and health care access between Indigenous and non-Indigenous people in Canada. The major quality challenge underlying these errors and biases is the lack of Indigenous specific identifiers that are consistent and relevant in major health and social data sources. The recent removal of an Indigenous identity question from the Canadian census has resulted in further deterioration of an already suboptimal system. A revision of core health data sources to include relevant, consistent, and inclusive Indigenous self-identification is urgently required. These changes need to be carried out in partnership with Indigenous peoples and their representative and governing organizations.

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“…Few longitudinal studies have characterized the predictors of CKD progression in Indigenous populations . In one remote Northern Australian community, albuminuria was the dominant predictor of eGFR decline .…”

Section: Introductionmentioning

confidence: 99%

“…4 Few longitudinal studies have characterized the predictors of CKD progression in Indigenous populations. 8 In one remote Northern Australian community, albuminuria was the dominant predictor of eGFR decline. 9 Our recent study of a geographically diverse Indigenous Australian cohort at high risk for ESKD confirmed this association between albuminuria and CKD progression and outcomes for all levels of baseline eGFR.…”

Section: Introductionmentioning

confidence: 99%