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Survival of Indigenous Australians receiving renal replacement therapy: closing the gap?

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Aboriginal and Torres Strait Islander people (respectfully referred to hereafter as Indigenous Australians) have a higher incidence of end-stage kidney disease requiring renal replacement therapy (RRT) than non-Indigenous Australians.1,2 A high proportion of Indigenous patients come from rural and remote areas,3 which are associated with markers of poorer socioeconomic status.4 They are more likely to receive haemodialysis and much less likely to receive a kidney transplant than non-Indigenous Australians.1,5

In the past 10 years, there have been concerted efforts across Australia to provide dialysis services in more remote areas.6 While providing support for self-care home haemodialysis and peritoneal dialysis in remote Australia has been challenging,79 haemodialysis units supported by nurses have been established in small towns and communities. The impact of remoteness on quality of life for Indigenous RRT patients has been well described,10 but its effect on survival has not. We do know that there is a small increase in the risk of death associated…