Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary

Introduction: First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Au...

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Published in:Medical Journal of Australia
Main Authors: Tunnicliffe, D.J., Bateman, S., Arnold-Chamney, M., Dwyer, K.M., Howell, M., Gebadi, A., Jesudason, S., Kelly, J., Lambert, K., Majoni, S.W., Oliva, D., Owen, K.J., Pearson, O., Rix, E., Roberts, I., Taylor, K., Wittert, G.A., Widders, K., Yip, A., Craig, J.
Format: Article in Journal/Newspaper
Language:English
Published: WILEY 2023
Subjects:
Online Access:https://hdl.handle.net/2440/139778
https://doi.org/10.5694/mja2.52114
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spelling ftunivadelaidedl:oai:digital.library.adelaide.edu.au:2440/139778 2023-12-17T10:30:11+01:00 Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary Tunnicliffe, D.J. Bateman, S. Arnold-Chamney, M. Dwyer, K.M. Howell, M. Gebadi, A. Jesudason, S. Kelly, J. Lambert, K. Majoni, S.W. Oliva, D. Owen, K.J. Pearson, O. Rix, E. Roberts, I. Taylor, K. Wittert, G.A. Widders, K. Yip, A. Craig, J. 2023 application/pdf https://hdl.handle.net/2440/139778 https://doi.org/10.5694/mja2.52114 en eng WILEY http://purl.org/au-research/grants/nhmrc/119733 Medical Journal of Australia, 2023; 219(8):374-385 0025-729X 1326-5377 https://hdl.handle.net/2440/139778 doi:10.5694/mja2.52114 Bateman, S. [0000-0002-1985-0035] Jesudason, S. [0000-0001-9695-0761] Kelly, J. [0000-0002-7497-302X] Wittert, G.A. [0000-0001-6818-6065] © 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. http://dx.doi.org/10.5694/mja2.52114 Guidelines as topic Kidney diseases Renal dialysis Health services Social determinants of health Journal article 2023 ftunivadelaidedl https://doi.org/10.5694/mja2.52114 2023-11-20T23:27:53Z Introduction: First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Australians. Nationwide community consultation (Kidney Health Australia, Yarning Kidneys, and Lowitja Institute, Catching Some Air) identified priority issues for guideline development. These guidelines uniquely prioritised the knowledge of the community, alongside relevant evidence using an adapted GRADE Evidence to Decision framework to develop specific recommendations for the management of CKD among First Nations Australians. Main recommendations: These guidelines explicitly state that health systems have to measure, monitor and evaluate institutional racism and link it to cultural safety training, as well as increase community and family involvement in clinical care and equitable transport and accommodation. The guidelines recommend earlier CKD screening criteria (age ≥ 18 years) and referral to specialists services with earlier criteria of kidney function (eg, estimated glomerular filtration rate [eGFR], ≤ 45 mL/min/1.73 m2 , and a sustained decrease in eGFR, > 10 mL/min/1.73 m2 per year) compared with the general population. Changes in management as result of the guidelines: Our recommendations prioritise health care service delivery changes to address institutional racism and ensure meaningful cultural safety training. Earlier detection of CKD and referral to nephrologists for First Nations Australians has been recommended to ensure timely implementation to preserve kidney function given the excess burden of disease. Finally, the importance of community with the recognition of involvement in all aspects and stages of treatment together with increased access to care on Country, particularly in rural and remote locations, including dialysis services. David J Tunnicliffe, Samantha Bateman, Melissa ... Article in Journal/Newspaper First Nations The University of Adelaide: Digital Library Medical Journal of Australia 219 8 374 385
institution Open Polar
collection The University of Adelaide: Digital Library
op_collection_id ftunivadelaidedl
language English
topic Guidelines as topic
Kidney diseases
Renal dialysis
Health services
Social determinants of health
spellingShingle Guidelines as topic
Kidney diseases
Renal dialysis
Health services
Social determinants of health
Tunnicliffe, D.J.
Bateman, S.
Arnold-Chamney, M.
Dwyer, K.M.
Howell, M.
Gebadi, A.
Jesudason, S.
Kelly, J.
Lambert, K.
Majoni, S.W.
Oliva, D.
Owen, K.J.
Pearson, O.
Rix, E.
Roberts, I.
Taylor, K.
Wittert, G.A.
Widders, K.
Yip, A.
Craig, J.
Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
topic_facet Guidelines as topic
Kidney diseases
Renal dialysis
Health services
Social determinants of health
description Introduction: First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Australians. Nationwide community consultation (Kidney Health Australia, Yarning Kidneys, and Lowitja Institute, Catching Some Air) identified priority issues for guideline development. These guidelines uniquely prioritised the knowledge of the community, alongside relevant evidence using an adapted GRADE Evidence to Decision framework to develop specific recommendations for the management of CKD among First Nations Australians. Main recommendations: These guidelines explicitly state that health systems have to measure, monitor and evaluate institutional racism and link it to cultural safety training, as well as increase community and family involvement in clinical care and equitable transport and accommodation. The guidelines recommend earlier CKD screening criteria (age ≥ 18 years) and referral to specialists services with earlier criteria of kidney function (eg, estimated glomerular filtration rate [eGFR], ≤ 45 mL/min/1.73 m2 , and a sustained decrease in eGFR, > 10 mL/min/1.73 m2 per year) compared with the general population. Changes in management as result of the guidelines: Our recommendations prioritise health care service delivery changes to address institutional racism and ensure meaningful cultural safety training. Earlier detection of CKD and referral to nephrologists for First Nations Australians has been recommended to ensure timely implementation to preserve kidney function given the excess burden of disease. Finally, the importance of community with the recognition of involvement in all aspects and stages of treatment together with increased access to care on Country, particularly in rural and remote locations, including dialysis services. David J Tunnicliffe, Samantha Bateman, Melissa ...
format Article in Journal/Newspaper
author Tunnicliffe, D.J.
Bateman, S.
Arnold-Chamney, M.
Dwyer, K.M.
Howell, M.
Gebadi, A.
Jesudason, S.
Kelly, J.
Lambert, K.
Majoni, S.W.
Oliva, D.
Owen, K.J.
Pearson, O.
Rix, E.
Roberts, I.
Taylor, K.
Wittert, G.A.
Widders, K.
Yip, A.
Craig, J.
author_facet Tunnicliffe, D.J.
Bateman, S.
Arnold-Chamney, M.
Dwyer, K.M.
Howell, M.
Gebadi, A.
Jesudason, S.
Kelly, J.
Lambert, K.
Majoni, S.W.
Oliva, D.
Owen, K.J.
Pearson, O.
Rix, E.
Roberts, I.
Taylor, K.
Wittert, G.A.
Widders, K.
Yip, A.
Craig, J.
author_sort Tunnicliffe, D.J.
title Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
title_short Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
title_full Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
title_fullStr Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
title_full_unstemmed Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary
title_sort recommendations for culturally safe clinical kidney care for first nations australians: a guideline summary
publisher WILEY
publishDate 2023
url https://hdl.handle.net/2440/139778
https://doi.org/10.5694/mja2.52114
genre First Nations
genre_facet First Nations
op_source http://dx.doi.org/10.5694/mja2.52114
op_relation http://purl.org/au-research/grants/nhmrc/119733
Medical Journal of Australia, 2023; 219(8):374-385
0025-729X
1326-5377
https://hdl.handle.net/2440/139778
doi:10.5694/mja2.52114
Bateman, S. [0000-0002-1985-0035]
Jesudason, S. [0000-0001-9695-0761]
Kelly, J. [0000-0002-7497-302X]
Wittert, G.A. [0000-0001-6818-6065]
op_rights © 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
op_doi https://doi.org/10.5694/mja2.52114
container_title Medical Journal of Australia
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container_issue 8
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