Australia & New Zealand Dialysis & Transplant (ANZDATA) Registry, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia; Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
Australia & New Zealand Dialysis & Transplant (ANZDATA) Registry, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, SA, Australia; Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
Aust N Z J Public Health. 2024 Aug;48(4):100161. doi: 10.1016/j.anzjph.2024.100161. Epub 2024 Jul 2.
To locate incident hotspots of dialysis demand in Australian capital cities and measure association with prevalent dialysis demand and socioeconomic disadvantage.
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.
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.
Novel spatial analyses of geo-referenced registry data located hotspots of kidney failure and associated socio-demographic and comorbid states.
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.
定位澳大利亚首府城市的透析需求事件热点，并测量其与普遍透析需求和社会经济劣势的关联。
采用回顾性队列研究，利用澳大利亚和新西兰透析和移植登记处的数据，对 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、因肾衰竭开始透析的人群进行研究。按统计区域 3 级（SA3）估计年龄性别标准化透析发病率，按 SA2 估计透析流行率。
根据居住的邮政编码，共参考了 32391 名在城市大都市区开始透析的人到 SA3。事件热点位于悉尼西部。标准发病率的年平均变化率最高为 8.3 百万人（经错误发现率校正的 95%置信区间为 1.0，15.7），在 Mount Druitt 地区，绝对需求从 2001-3 年到 2019-21 年增加了 263%。糖尿病肾病引起的新发病例透析对总需求增长贡献较大。事件热点与普遍透析需求与社会经济贫困相关的地区相重合。
对地理参考登记数据进行的新的空间分析定位了肾衰竭及其相关社会人口学和合并症的热点。
这些分析提高了在地方一级规划透析能力的能力。可以针对热点地区进行预防和减缓肾脏疾病的进展。
