Prevention and management

In many Aboriginal and Torres Strait Islander communities, the prevention, control and management of kidney disorders depend not only on effective, culturally appropriate treatment, but also on actions to address the poor socioeconomic conditions that contribute to these disorders, including:

  • poverty
  • limited access to primary and other medical care
  • poor living conditions
  • lack of adequate environmental sanitation [21677][3497][21349].

Managing kidney disease may involve a number of lifestyle changes. These changes help to protect the kidneys from further damage, and include:

  • controlling blood pressure
  • controlling blood glucose (if the person has diabetes)
  • working with a health care team to monitor kidney health
  • taking medicines as prescribed
  • maintaining a healthy diet, sometimes with the help of a nutritionist
  • being physically active
  • maintaining a healthy bodyweight
  • getting enough sleep
  • quitting smoking
  • coping with stress and depression [28715].

If the kidneys stop working properly – as is the case when someone has end-stage kidney disease (ESKD) – waste can build up in the blood and damage the body [21677][28715]. A person many need dialysis to help the damaged kidneys do their job. Dialysis is the mechanical filtering of the blood to help maintain functions normally performed by the kidneys. There are two types of dialysis:

  • haemodialysis (HD): blood passes through tubes from the body to a dialysis machine where it is filtered (cleaned) before being returned to the body. Haemodialysis is usually performed at a hospital or medical centre
  • peritoneal dialysis (PD): the dialysis solution (a fluid containing a type of sugar that draws waste products and extra fluid out of the blood) is pumped into the patient’s abdomen. After a couple of hours the fluid is drained out, taking the wastes with it. Peritoneal dialysis can be performed by patients in their own homes.

Dialysis is the leading cause of hospitalisation among Aboriginal and Torres Strait Islander people, accounting for almost half of Aboriginal and Torres Strait Islander hospital admissions [33151]. When dialysis facilities are not available near to where the Indigenous patient lives, they are forced to move to regional centres or major cities to undertake dialysis. The lack of treatment available in remote areas and the limited availability of transplant facilities create geographical barriers to treatment.

Transplantation is the ideal form of treatment for most ESKD patients [342]. Transplantation involves taking a healthy kidney from either a living or recently deceased donor and implanting it in a patient. The diseased kidneys are usually left in place. Living donors are often relatives of the patient. Aboriginal and Torres Strait Islander people are much less likely to get a kidney transplant than non-Indigenous people [33151].


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Watiya-warnu Jukurrpa (Seed Dreaming) by Evelyn Nangala Robertson

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