Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
Saskatchewan Transplant Program, St. Paul's Hospital, 1702 20Th Street West, Saskatoon, SK, S7M 0Z9, Canada.
Int Urol Nephrol. 2024 Nov;56(11):3545-3558. doi: 10.1007/s11255-024-04122-5. Epub 2024 Jun 20.
This study aims to review the escalating prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) among Canada's Indigenous population, focusing on risk factors, hospitalization and mortality rates, and disparities in kidney transplantation. The study explores how these factors contribute to the health outcomes of this population and examines the influence of genetic variations on CKD progression.
The review synthesizes data on prevalence rates, hospitalization and mortality statistics, and transplantation disparities among Indigenous individuals. It also delves into the complexities of healthcare access, including geographical, socioeconomic, and psychological barriers. Additionally, the manuscript investigates the impact of racial factors on blood characteristics relevant to dialysis treatment and the genetic predispositions influencing disease progression in Indigenous populations.
Indigenous individuals exhibit a higher prevalence of CKD and ESRD risk factors such as diabetes and obesity, particularly in regions like Saskatchewan. These patients face a 77% higher risk of death compared to their non-Indigenous counterparts and are less likely to receive kidney transplants. Genetic analyses reveal significant associations between CKD and specific genomic variations. Through analyses, we found that healthy Indigenous individuals may have higher levels of circulating inflammatory markers, which could become further elevated for those with CKD. In particular, they may have higher levels of C-reactive protein (CRP) fibrinogen, as well as genomic variations that affect IL-6 production and the function of von Willebrand Factor (vWF) which has critical potential influence on the compatibility with dialysis membranes contributing to complications in dialysis.
Indigenous people in Canada are disproportionately burdened by CKD and ESRD due to socioeconomic factors and potential genetic predispositions. While significant efforts have been made to assess the socioeconomic conditions of the Indigenous population, the genetic factors and their potential critical influence on compatibility with dialysis membranes, contributing to treatment complications, remain understudied. Further investigation into these genetic predispositions is essential.
本研究旨在回顾加拿大原住民群体慢性肾脏病（CKD）和终末期肾病（ESRD）的患病率不断上升的情况，重点关注风险因素、住院率和死亡率，以及肾脏移植方面的差异。本研究探讨了这些因素如何影响该人群的健康结果，并研究了遗传变异对 CKD 进展的影响。
本综述综合了原住民个体的患病率、住院率和死亡率统计数据以及肾脏移植差异方面的数据。它还深入探讨了医疗保健获取的复杂性，包括地理、社会经济和心理障碍。此外，本文还研究了种族因素对与透析治疗相关的血液特征的影响，以及影响原住民人群疾病进展的遗传倾向。
原住民个体表现出更高的 CKD 和 ESRD 风险因素的患病率，如糖尿病和肥胖症，特别是在萨斯喀彻温省等地区。与非原住民相比，这些患者的死亡风险高 77%，并且更不可能接受肾脏移植。遗传分析显示 CKD 与特定基因组变异之间存在显著关联。通过分析，我们发现健康的原住民个体可能具有更高水平的循环炎症标志物，而对于 CKD 患者，这些标志物可能进一步升高。特别是，他们可能具有更高水平的 C 反应蛋白（CRP）、纤维蛋白原，以及影响白细胞介素 6（IL-6）产生和血管性血友病因子（vWF）功能的基因组变异，这对与透析膜的相容性具有重要潜在影响，从而导致透析并发症。
由于社会经济因素和潜在的遗传易感性，加拿大原住民不成比例地受到 CKD 和 ESRD 的困扰。虽然已经做出了很大努力来评估原住民的社会经济状况，但遗传因素及其对与透析膜的相容性的潜在关键影响，导致治疗并发症，仍然研究不足。进一步研究这些遗传倾向至关重要。
