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living conditions and health status among AboriginalAustralians. The approach to kidney and cardiovasculardisease prevention among Aboriginal people needs to bebroad-based, and extend beyond traditional risk-factorsto include consideration of infections both as a directpathologic cause, and more importantly of repeatedexposure to bacterial infection as a marker of a high-riskenvironment. A logical outcome of this is a broadeningof risk-factor modification approaches at both anindividual and community level.Finally, this area is an example of the value of diseaseregistries. Although ESKD is a relatively rare disease, thedocumentation and subsequent efforts to address thehigh rates of kidney disease among Aboriginal peoplebegan with the reporting of high rates of ESKD, and theepidemiology of ESKD has been an important basis forthe investigation in this area.Further readingThe themes in this brief review are further developed in36, 42, 45-47several manuscripts.References1. Hoy WE, Norman RJ, Hayhurst BG, et al. A healthprofile of adults in a Northern Territory Aboriginalcommunity, with an emphasis on preventablemorbidities. Aust N Z J Public Health. 1997;21:121-126.2. McDonald SP, Maguire GP, Hoy WE. Renal functionand cardiovascular risk markers in a remote AustralianAboriginal community. Nephrol Dial Transplant.2003;18:1555-1561.3. Eiser D. Microalbuminuria and cardiovascular riskfactors in Central Australian Aboriginal Communities.In: Department of Medicine, Melbourne, Universityof Melbourne;1995, 73.4. Rowley KG, Iser DM, Best JD, et al. Albuminuriain Australian Aboriginal people: prevalence andassociations with components of the metabolicsyndrome. Diabetologia. 2000;43:1397-1403.5. Shephard M, James J, Allen G, et al. A preventativemodel for Aboriginal kidney disease. In: Departmentof Renal Medicine (vol 1999), Flinders MedicalCentre, Adelaide; 1999.6. Hoy W, Wang Z, van Buynder P, et al. The naturalhistory of renal disease in Australian Aborigines.Part 2. Albuminuria predicts natural death and renalfailure. Kidney Int. 2001;60:249-256.7. McDonald SP, Russ GR. Current incidence, treatmentpatterns and outcome of end-stage renal diseaseamong indigenous groups in Australia and NewZealand. Nephrology. 2003;8:42-48.148. Trewin D, Madden R. The Health and Welfare ofAustralia’s Aboriginal and Torres Strait IslanderPeoples. ABS Catalogue number 4704.0. In:Australian Bureau of Statistics, Canberra; 2005.9. Carapetis JR, Connors C, Yarmirr D, et al. Success ofa scabies control program in an Australian aboriginalcommunity. Pediatr Infect Dis J. 1997;16:494-499.10. Nimmo GR, Tinniswood RD, Nuttall N, et al. Group Astreptococcal infection in an Aboriginal community.Med J Aust. 1992;157:521-522.11. Streeton CL, Hanna JN, Messer RD, et al.An epidemic of acute post-streptococcalglomerulonephritis among aboriginal children. JPaediatr Child Health. 1995;31:245-248.12. Van Buynder PG, Gaggin JA, Martin D, et al.Streptococcal infection and renal disease markersin Australian aboriginal children. Med J Aust.1992;156:537-540.13. Cunningham J, Condon JR. Premature mortality inAboriginal adults in the Northern Territory, 1979-1991.Med J Aust. 1996;165:309-312.14. Dempsey K, Condon J. Mortality in the NorthernTerritory 1979-1997. 1 ed. Darwin, Territory HealthServices; 1999.15. Durie MH. The health of indigenous peoples. BMJ.2003;326:510-511.16. Plant A, Condon J, Durling G. Northern Territoryhealth outcomes: morbidity and mortality 1979-1991.Darwin, NT Department of Health and CommunityServices; 1995.17. Bastian P. Coronary heart disease in tribal Aborigines :the West Kimberley survey. Aust N Z J Med.1979;9:284-292.18. Edwards FM, Wise PH, Thomas DW, et al. Bloodpressures and electrocardiographic findings inthe South Australian Aborigines. Aust N Z J Med.1976;6:197-205.19. Simons L, Whish P, Marr B, et al. Coronary riskfactors in a rural community which includesAborigines: Inverell Heart Disease PreventionProgramme. Aust N Z J Med. 1981;11:386-390.20. Markey P. The prevalence of ischaemic and rheumaticheart disease and risk factors in Aboriginal and non-Aboriginal footballers. In: Department of CommunityMedicine, Adelaide, University of Adelaide; 1996, 117.21. Sladden T. Cardiovascular disease risk factors inadults of an Aboriginal community. In: MenziesSchool of Health Research, Darwin, University ofSydney; 1990, 135.22. Smith RM, Spargo RM, Hunter EM, et al. Prevalenceof hypertension in Kimberley Aborigines and itsrelationship to ischaemic heart disease. An agestratifiedrandom survey. Med J Aust. 1992;156:557-562.
23. Gracey M, Spargo RM, Smith P, et al. Risk factorsfor ill-health in a remote desert-dwelling Aboriginalcommunity in Western Australia. Aust N Z J Med.1996;26:171-179.24. Guest CS, O’ Dea K, Larkins RG. Blood pressure,lipids and other risk factors for cardiovascular diseasein Aborigines and persons of European descentof southeastern Australia. Aust J Public Health.1994;18:79-86.25. Braun B, Zimmermann MB, Kretchmer N, et al.: Riskfactors for diabetes and cardiovascular disease inyoung Australian Aborigines. A 5-year follow-up study.Diabetes Care. 1996;19:472-479.26. Gault A, O’Dea K, Rowley KG, et al. Abnormalglucose tolerance and other coronary heart diseaserisk factors in an isolated Aboriginal community incentral Australia. Diabetes Care. 1996;19:1269-1273.27. Hoy WE, Mathews JD, McCredie DA, et al. Themultidimensional nature of renal disease: rates andassociations of albuminuria in an Australian Aboriginalcommunity. Kidney Int. 1998;54:1296-1304.28. Go AS, Chertow GM, Fan D, et al. Chronic KidneyDisease and the Risks of Death, CardiovascularEvents, and Hospitalization. N Engl J Med.2004;351:1296-1305.29. Hillege HL, Janssen WM, Bak AA, et al.Microalbuminuria is common, also in a nondiabetic,nonhypertensive population, and an independentindicator of cardiovascular risk factors andcardiovascular morbidity. J Intern Med. 2001;249:519-526.30. Janssen WM, Hillege H, Pinto-Sietsma SJ, et al. Lowlevels of urinary albumin excretion are associatedwith cardiovascular risk factors in the generalpopulation. Clin Chem Lab Med. 2000;38:1107-1110.31. Hoy W, Wang Z, van Buynder P, et al. The naturalhistory of renal disease: Part 1. Changes inalbuminuria and glomerular filtration rate over time ina community-based cohort of Australian Aborigineswith high rates of renal disease. Kidney Int.2001;60:243-248.32. Wang Z, Hoy WE. Albuminuria and incident coronaryheart disease in Australian Aboriginal people. KidneyInternational. 2005;68:1289-1293.33. Shaw JT, McWhinney B, Tate JR, et al. Plasmahomocysteine levels in indigenous Australians. Med JAust. 1999;170:19-22.34. McDonald SP, Excel L. ANZDATA Registry Report2005. Adelaide, Australia and New Zealand Dialysisand Transplant Registry; 2005.35. White AV, Hoy WE, McCredie D. Childhood poststreptococcalglomerulonephritis as a risk factorfor chronic renal disease in later life. Med J Aust.2001;174:492-496.1536. Hoy W, Vanbuynder P, Mathews JD, et al. Renaldisease and the environment: lessons fromAboriginal Australia. Nephrology. 2001;6:19-24.37. Ridker PM, Cushman M, Stampfer MJ, et al.Inflammation, aspirin, and the risk of cardiovasculardisease in apparently healthy men. N Engl J Med.1997;336:973-979.38. McDonald SP, Maguire GP, Duarte NL, et al. Creactive protein, cardiovascular risk, and renal diseasein a remote Australian Aboriginal community. Clin SciLondon. 2003;106:121-128.39. Rowley K, Walker KZ, Cohen J, et al. Inflammationand vascular endothelial activation in an Aboriginalpopulation: relationships to coronary diseaserisk factors and nutritional markers. Med J Aust.2003;178:495-500.40. Wang Z, Hoy WE. Population distribution of highsensitivity C-reactive protein values in AboriginalAustralians: A comparison with other populations.Clin Biochem. 2006;39:277-281.41. McDonald SP, Maguire GP, Duarte NL, et al. Carotidintima-media thickness, cardiovascular risk factorsand albuminuria in a remote Australian Aboriginalcommunity. Atherosclerosis. 2004;177:423-431.42. Cass A, Cunningham J, Snelling P, et al. End-stagerenal disease in indigenous Australians: a disease ofdisadvantage. Ethn Dis. 2002;12:373-378.43. Cass A, Cunningham J, Wang Z, et al. Socialdisadvantage and variation in the incidence of endstagerenal disease in Australian capital cities. Aust NZ J Public Health. 2001;25:322-326.44. Marmot M. Epidemiology of socioeconomic statusand health: are determinants within countries thesame as between countries? Ann N Y Acad Sci.1999;896:16-29.45. McDonald SP, Hoy W. Interfaces betweencardiovascular and renal disease among AboriginalAustralians. Adv Chronic Kid Dis. In Press; 2005.46. Hoy W, McDonald S, Cass A, et al. A broader view ofrenal disease: Findings in Aboriginal Australia. RecentAdv Microbiol. 2002; chapter 5: 75-96.47. Cass A, Cunningham J, Snelling P, et al. Exploring thepathways leading from disadvantage to end-stagerenal disease for indigenous Australians. Soc SciMed. 2004;58:767-785.
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