Renal dialysis unit marks a first for Indigenous Australians

Dialysis

25 Jun 2024

First Nations Australians with severe kidney disease will have better access to dialysis in remote areas following the unveiling of the first of dozens of new units.

The Coober Pedy renal dialysis clinic is the first to open under the federal government’s $73.2 million Better Renal Services for First Nations Peoples initiative, which will provide up to 30 dialysis units, including workforce accommodation in SA, WA and the NT, to help treat end-stage renal disease.

Data show First Nations adults are twice as likely as non-Indigenous adults to have chronic kidney disease and almost four times as likely to die from the disease.

The idea behind the initiative is that by providing dialysis treatment closer to home, patients will experience treatment more regularly as well as continued support and care, while remaining on Country and connected to their community and family.

Previously, patients from Coober Pedy and surrounding communities had to relocate 850km south to Adelaide to start dialysis and, once stable, could apply to have dialysis in Port Augusta or Whyalla, which are more than 500km away from home.

The clinic could also help ease financial and emotional hardship for patients as well as lessen the stress and anxiety associated with language or cultural barriers.

The Coober Pedy clinic has capacity to accomodate about eight patients per week, with the potential to double the number of patients at times of high demand.

Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation, also known as Purple House, will deliver the new services in Coober Pedy.

“This new dialysis unit will make a significant, positive difference to the lives of First Nations people in Coober Pedy while helping to close the gap,” said federal Assistant Minister for Indigenous Health, Malarndirri McCarthy.

Call to prioritise ATSI patients

The new program comes as Adelaide nephrologists are calling for health professionals to prioritise kidney transplants for First Nations patients, after their study identified a clear survival benefit in patients over remaining on dialysis.

The researchers said the waitlisting rate for Aboriginal and Torres Strait Islander people was “alarmingly low”, with only 11% of those commencing dialysis waitlisted during 2006–2020 compared with 24% of non-Indigenous patients.

Their retrospective study involved 4082 Aboriginal and Torres Strait Islander people receiving dialysis, of whom 450 were waitlisted for kidney transplantation (11%).

Of those waitlisted, 323 received deceased donor transplants.

Transplantation was associated with a significant survival benefit compared with remaining on dialysis after 12 months (adjusted hazard ratio [aHR], 0.38), which was similar to that of non-Indigenous people receiving transplants (aHR 0.47), according to findings published in the Medical Journal of Australia [link here].

“Taken in conjunction with the strong and consistent message from the Aboriginal and Torres Strait Islander community that transplantation is the treatment most likely to improve quality of life and connection to culture and Country, our findings should allay concerns about the benefit of kidney transplantation for Aboriginal and Torres Strait Islander people, and support initiatives across Australia to increase rates of transplantation,” the authors said.

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