Hotspots of kidney failure: Analysing Australian metropolitan dialysis demand for service planning

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Australian and New Zealand Journal of Public Health Pub Date : 2024-07-02 DOI:10.1016/j.anzjph.2024.100161

Dominic Keuskamp , Christopher E. Davies , Shilpanjali Jesudason , Stephen P. McDonald

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Abstract

Objective

To locate incident hotspots of dialysis demand in Australian capital cities and measure association with prevalent dialysis demand and socioeconomic disadvantage.

Methods

A retrospective cohort study used Australia and New Zealand Dialysis and Transplant Registry data on people commencing dialysis for kidney failure (KF) resident in an Australian capital city, 1 January 2001 – 31 December 2021. Age-sex-standardised dialysis incidence was estimated by Statistical Area Level 3 (SA3) and dialysis prevalence by SA2.

Results

A total of 32,391 people commencing dialysis were referenced to SA3s within city metropolitan areas based on residential postcode. Incident hotspots were located in Western Sydney. The highest average annual change of standardised incidence was 8.3 per million people (false discovery rate-corrected 95% CI 1.0,15.7) in Mount Druitt, reflecting a 263% increase in absolute demand from 2001-3 to 2019-21. Incident dialysis for diabetic kidney disease contributed substantially to total growth. Incident hotspots were co-located with areas where prevalent dialysis demand was associated with socioeconomic deprivation.

Conclusions

Novel spatial analyses of geo-referenced registry data located hotspots of kidney failure and associated socio-demographic and comorbid states.

Implications for Public Health

These analyses advance current abilities to plan dialysis capacity at a local level. Hotspots can be targeted for prevention and slowing the progression of kidney disease.

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肾衰竭的热点地区：分析澳大利亚大都市透析需求以制定服务规划。

目的确定澳大利亚首府城市的透析需求事件热点，并衡量与普遍透析需求和社会经济劣势之间的关联：这项回顾性队列研究使用了澳大利亚和新西兰透析与移植登记处的数据，这些数据涉及 2001 年 1 月 1 日至 2021 年 12 月 31 日期间居住在澳大利亚首府城市的肾衰竭（KF）透析患者。按统计区三级（SA3）估算年龄-性别标准化透析发病率，按统计区二级估算透析流行率：共有 32,391 人开始透析，根据居住地邮政编码参照了城市都市区内的 SA3。事件热点位于悉尼西部。德鲁伊特山的标准化发病率年均变化最高，为每百万人中有8.3人（误诊率校正后的95% CI为1.0,15.7），反映出从2001-3年到2019-21年，绝对需求量增加了263%。糖尿病肾病的发病透析对总增长贡献巨大。发病热点地区与普遍存在的透析需求与社会经济贫困相关联：结论：通过对地理参照登记数据进行新颖的空间分析，找到了肾衰竭的热点地区以及相关的社会人口和合并症状况：这些分析提高了目前在地方一级规划透析能力的能力。热点地区可作为预防和减缓肾脏疾病进展的目标。

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来源期刊

Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

5.70%

发文量

121

审稿时长

6-12 weeks

期刊介绍： The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.