Yeates K, Tonelli M
Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Clin Nephrol. 2010 Nov;74 Suppl 1:S57-60. doi: 10.5414/cnp74s057.
Chronic kidney disease (CKD) poses a significant health burden on Aboriginal communities around the world. High rates of diabetes among Aboriginal Canadians are an important contributing factor to the rising rates of CKD in this population, and diabetes has been the leading cause of kidney failure among Aboriginal patients initiating dialysis in Canada for the last decade. This paper will describe access to, quality of, and outcomes associated with the renal care of Aboriginal people living in Canada.
Research shows that rates of CKD are higher among Aboriginal people residing in Canada, and that despite remote residence location, use of peritoneal dialysis is substantially lower than in white patients. Similarly, although mortality rates among Canadian hemodialysis patients are similar for Aboriginals and for whites, Aboriginal patients have substantially reduced access to kidney transplantation.
A concerted effort to lower rates of CKD in this population is needed. Changes in healthcare policy that successfully translate into healthcare provider and patient level improvements in access to and the quality of care will be needed to significantly reduce the risk of CKD and progression to kidney failure.
慢性肾脏病（CKD）给世界各地的原住民社区带来了沉重的健康负担。加拿大原住民中糖尿病的高发病率是该人群CKD发病率上升的一个重要因素，在过去十年中，糖尿病一直是加拿大开始透析的原住民患者肾衰竭的主要原因。本文将描述居住在加拿大的原住民获得肾脏护理的情况、护理质量以及相关结果。
研究表明，居住在加拿大的原住民中CKD发病率较高，尽管居住地点偏远，但腹膜透析的使用率远低于白人患者。同样，虽然加拿大血液透析患者中，原住民和白人的死亡率相似，但原住民患者接受肾脏移植的机会大幅减少。
需要齐心协力降低该人群的CKD发病率。需要改变医疗政策，并成功转化为医疗服务提供者和患者在获得护理的机会和护理质量方面的改善，以显著降低CKD风险和肾衰竭进展。
