Remote Dwelling Location Is a Risk Factor for CKD Among Indigenous Canadians

Introduction: Rural and remote indigenous individuals have a high burden of chronic kidney disease (CKD) when compared to the general population. However, it has not been previously explored how these rates compare to urban-dwelling indigenous populations. Methods: In a recent cross-sectional screen...

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Bibliographic Details
Published in:Kidney International Reports
Main Authors: Oksana Harasemiw, Shannon Milks, Louise Oakley, Barry Lavallee, Caroline Chartrand, Lorraine McLeod, Michelle Di Nella, Claudio Rigatto, Navdeep Tangri, Thomas Ferguson, Paul Komenda
Format: Article in Journal/Newspaper
Language:English
Published: Elsevier 2018
Subjects:
Diseases of the genitourinary system. Urology
RC870-923
Canada
First Nations
Online Access:https://doi.org/10.1016/j.ekir.2018.02.002
https://doaj.org/article/668098acf0eb4e519cf47f007265c419
Description
Summary:Introduction: Rural and remote indigenous individuals have a high burden of chronic kidney disease (CKD) when compared to the general population. However, it has not been previously explored how these rates compare to urban-dwelling indigenous populations. Methods: In a recent cross-sectional screening study, 1346 adults 18 to 80 years of age were screened for CKD and diabetes across 11 communities in rural and remote areas in Manitoba, Canada, as part of the First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis (FINISHED) program. An additional 284 Indigenous adults who resided in low-income areas in the city of Winnipeg, Manitoba, Canada were screened as part of the NorWest Mobile Diabetes and Kidney Disease Screening and Intervention Project. Results: Our findings indicate that a gradient of CKD and diabetes prevalence exists for Indigenous individuals living in different geographic areas. Compared to urban-dwelling Indigenous individuals, rural-dwelling individuals had more than a 2-fold (2.1, 95% CI = 1.4−3.1) increase in diabetes whereas remote-dwelling individuals had a 4-fold (4.1, 95% CI = 2.8−6.0) increase, and more than a 3-fold (3.1, 95% CI = 2.2−4.5) increase in CKD prevalence. Conclusion: Although these results highlight the relative importance of geography in determining the prevalence of diabetes and CKD in Indigenous Canadians, geography is but an important surrogate of other determinants, such as poverty and access to care. Keywords: chronic kidney disease, Indigenous Canadians, remoteness, rurality, screening, social determinants of health

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