• To provide a better understanding of how positive clinical outcomes can be obtained and what components of chronic kidney disease (CKD) management programs influence or enhance acceptability for patients and result in cost-effective care for Indigenous Australians.
  1. What are the elements of effective CKD programs that attain positive clinical outcomes?
  2. What components of CKD management programs lead to enhanced Indigenous engagement/participation with health services, increased confidence in self-management and demonstrate improved acceptability, including patient satisfaction?
  3. What are the barriers and enablers to implementation of CKD management programs in Indigenous populations?
  4. What is the evidence of the cost-effectiveness of CKD management programs, in terms of the costs relative to the benefits of the programs/models, from the perspectives of individual patients and their families, the primary health services and tertiary health services?

Chronic kidney disease (CKD) and associated chronic illnesses, including heart disease, stroke and diabetes, constitute half of the gap in life expectancy between Indigenous and non-Indigenous Australians. CKD occurs more frequently and in younger age groups among Aboriginal and Torres Strait Islander people, with rates 3–5 times the national average in urban areas and up to 30 times the national average in remote areas.

Mortality rates are correspondingly high; reports from Queensland, South Australia, Western Australia and the Northern Territory (NT) list CKD as a primary or associated cause of death in 16% of Indigenous deaths, a rate at least 3.5 times higher than the national average.

The Commonwealth Department of Health has requested a systematic review and evidence synthesis of national and international CKD intervention and management programs.

Implications for policy and practice:

Knowledge acquired from this review may be used to inform the design and implementation of CKD management programs for Aboriginal and Torres Strait Islander populations in Australia.

Our research has found:

CKD is a progressive loss of kidney function that results in significant morbidity and mortality. It is increasingly recognised as a major health burden and a significant contributor to the rising tide of non-communicable disease worldwide.

Despite growing recognition in some parts of the health community, public awareness of CKD and awareness amongst primary health services of the risk factors for CKD remains low.

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  • Australian Government 
  • South Australian Health and Medical Research Institute (SAHMRI)
  • Joanna Briggs Institute (JBI)