The Central Australian Aboriginal Renal Disease Registry

Abstract

The Central Australian Aborigines (CAA) have a very high incidence of renal disease, up to 10 times more than other Australians in certain cohort groups. The mean age of CAA with end-stage chronic renal failure (CRF) is 10 years younger than others and the mortality rate due to CRF iS higher across all age groups. The aetiology of this high incidence of renal disease remains unclear as no organized study has been undertaken so far. Hence a Renal Disease Registry was initiated with the main purpose of setting up a database in order to determine the relative incidence, aetiology and natural history of different types of renal disease in CAA. In addition, the Registry would also be used in the recall and follow-up of patients to facilitate better management in an attempt to retard the progression of CRF. Analysis of the data collected since 1987 shows that the incidence of end-stage CRF among CAA has doubled every 3 years. The pattern of renal diseases observed indicates that the CAA form a distinct group with several peculiarities. Some diseases such as membranous nephropathy and adult polycystic kidney disease are extremely rare while other diseases such as amyloidosis are seen more often. A type of non-immune complex disease, characterized by marked glomerulomegaly and indices of progressive nephron loss of uncertain aetiology, appears to be unique to this group. The deterioration of renal function in some diseases such as diabetic nephropathy is much more rapid than observed elsewhere. Comorbidities such as hypertension, obesity, malnutrition and intercurrent infections are common and appear to contribute to the rapid deterioration of CRF. Continued collection of prospective data over the next few years should yield valuable information and lead to improved strategies towards prevention and management of renal disease in CAA.