Kidney Disease is a killer across Whanau Maori. Kidney disease has a disproportionately large impact on Māori, leading to higher rates of chronic kidney disease (CKD), end-stage renal failure, and a greater need for dialysis compared to other ethnic groups in New Zealand. Contributing factors include a higher prevalence of risk factors like diabetes and hypertension, socio-economic disadvantages, systemic bias, delayed diagnoses, and cultural barriers within the healthcare system. Ok that’s a lot to take on so what more can we do to get checked out and even prevent Kidney Disease in our whanau? Māori experience significantly higher rates of kidney disease, with studies showing they are approximately three to four times more likely to commence dialysis for end-stage kidney disease (ESKD) than New Zealand Europeans.
Key Statistics and Disparities
- Higher Prevalence: In an Auckland-based study, chronic kidney disease (CKD) was found in 10.4% of Māori patients tested, compared with 7.1% of non-Māori/non-Pacific patients.
- End-Stage Renal Disease (ESRD): Māori and Pacific people make up 58% of the dialysis population, despite being a much smaller percentage of the total New Zealand population.
- Primary Cause: Diabetes is the cause of kidney failure in a large proportion of Māori patients starting kidney treatment (around 67%), which is much higher than the rate for European patients (around 20%). Māori with diabetes are three and a half times more likely to have renal failure than non-Māori with diabetes.
- Treatment Disparities: Māori are less likely to receive a pre-emptive kidney transplant or use home-based dialysis compared to New Zealand Europeans. They also experience lower life expectancy on dialysis.
Contributing Factors
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The higher rates and poorer outcomes for Māori with kidney disease are due to a complex interplay of factors beyond just underlying health conditions, including:
- Socioeconomic deprivation, which is a known risk factor for ESKD.
- Systemic inequities and barriers within the healthcare system, such as late referral to specialist care and difficulties in accessing transplantation services.
- Higher prevalence of associated risk factors like obesity and hypertension.
- Potential genetic predispositions and a history of marginalisation within the health system, leading to issues with trust and engagement.
Kath Eastwood, CEO of the Kidney Society and Vanessa Kipa joined Matthew Tukaki for a korero.
