Kidney disease among the indigenous peoples of Oceania.

The prevalence of kidney disease is increasing among the indigenous peoples of Oceania--the region of the world that includes Australia, New Zealand, Papua New Guinea, and thousands of smaller islands. The number of indigenous people with early kidney disease is hard to quantify, but risk factors, including hypertension and diabetes, are widespread. The incidence of kidney failure is known in major population centers, where dialysis treatments are available, but few data are available elsewhere in Oceania. Nevertheless, the incidence of end-stage renal disease among Aborigines, Torres Straits Islanders, Pacific Islanders and Maori is considerably higher than in the surrounding non-indigenous populations, and most of the kidney failure is attributed to diabetes. Despite the high incidence of kidney failure among indigenous people, few receive kidney transplants, and geographic and economic constraints limit the availability of dialysis treatment. Consequently, clinical management should emphasize prevention, screening, and early intervention.