Renal disease in the Aboriginal community of Woorabinda

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Abstract
Objective:  An apparent increase in the incidence of end‐stage renal disease had been observed in the Australian Aboriginal community of Woorabinda. This study documents the incidence of end‐stage renal disease (ESRD) in Woorabinda, and correlates this with predictors of renal disease. Design:  The methodology included a retrospective audit of deaths from, and cases commencing treatment for ESRD between 1999 and 2001 in Woorabinda, and a cross‐sectional study. Participants:  The 183 participants were Aboriginal residents over 15 years of age. Females numbered 102 (55.7%) and males 81 (44.3%). Main outcome measure:  The incidence of ESRD was comparable to other recognised high incidence Indigenous communities in Australia. This was corroborated by a high prevalence of predictors of renal disease. Results:  Audit: the year 2001 age‐ and sex‐standardised incidence ratio for commencement of renal replacement therapy is 93.18 (95% CI, 25.34–238.53). Clinical Study: the prevalence of overt albuminuria was 7.6%; 11.7% had an albumin : creatinine ratio >3.4–33.9 g mol−1; 33.3% had microalbuminuria of ≥20 mg L−1; and 67.8% prevalence of proteinuria was found. The prevalence of diabetes was 18.6%, with another 13.2% having impaired fasting glucose. There was a 19.7% prevalence of hypertension. Of those with hypertension 22.2% had overt albuminuria.Conclusions:  Although Woorabinda was previously placed in a region of low end‐stage renal disease incidence, further investigation has identified a high incidence of renal disease, not exclusively due to diabetes. The finding raises questions regarding the current trajectory of the epidemic in other Aboriginal and Torres Strait Islander communities.