End-Stage Renal Disease - PDF

Running Head: END-STAGE RENAL DISEASE 1
End-Stage Renal Disease
Student’s name
Institutional Affiliations
End-Stage Renal Disease

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Part A
The rates at which the incidence and prevalence of the end-stage renal disease are rising
among the indigenous Australians provides a fundamental reason for studying the situation.
Statistics on health reports reveal that the end-stage renal disease is higher among the aboriginal
populations than on the rest of the Australian population. Moreover, the issue raises an
important aspect of reflection due to the high mortality rates of indigenous Australians who
succumb to the disease as well as other co-morbid infections. Also, a particular case among the
indigenous Australian population where the individuals contract the disease ten years earlier than
the non-indigenous Australians. The situation is also unique to other illnesses that characterize
the infection of the end-stage renal disease among indigenous Australians. Thus, there is a need
for intervention to prevent and reduce the death rate of indigenous Australians who make up
3.3% of the total Australian population as stated by the 2011 census of Australia. Therefore, this
paper will discuss primary epidemiological research of the end-stage renal disease among the
indigenous Australian population and the strategy that can be used to address the situation at
different levels of the society.
Various epidemiological researchers conducted by scholars and healthcare professionals
have revealed the significance of studying the end-stage renal disease of Australia. As far as the
disease is concerned, its prevalence and incidence among the indigenous Australians are unique
than in the rest of the Australians. It varies with age, gender and the methodology of treatment
subjected to the affected individuals. Also, epidemiological researchers reveal that the results
that take place after treatment are more inferior and fatal among the indigenous Australians than
in the rest of the Australians (Luyckx et al., 2013).

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Another factor of significance is that the disease has a higher comorbidity prevalence
which is more complicated than in the non-indigenous population. Therefore, the rate of
stabilizing the situation is slow in indigenous individuals thus explaining why the overall
population of their community is still lower than other ethnic groups in Australia. Additionally,
the case has rendered the health status of indigenous individuals in Australia as poor, and their
life expectancy is relatively lesser than the rest of individuals in the Australian population
(Yeates et al., 2009). Correspondingly, their health situation is characterized by social
determinants of health such as poverty, low education levels, high cases of unemployment, high
rates of drug and substance abuse, poor nutrition and an overall situation a low socioeconomic
status (Mitrou et al, 2014).
Research on the incidence of end-stage renal disease conducted by the ADZDATA
Registry reveal data of people receiving chronic dialysis collected in Australia. Hence, the
statistical figures reveal that approximately four hundred indigenous individuals out of every one
million Australians are enrolled in renal replacement therapy. Comparisons between the previous
and current statistical information show that there was an increased incidence rate of the end-
stage renal disease among the indigenous Australians before 2000 (Siva,2011). Since then, the
data indicates stability and slow infection rates of the disease in the same population. However,
the data does not offer clarity of whether the stabilization of the incidence rates has resulted from
the underlying chronic kidney infections or from a propensity to treat the infection facilitated by
expansion of renal services in Australian health facilities. Furthermore, an epidemiological study
conducted by the Registry reveal that there was no a significant difference of people treated with
the end-stage renal disease in both indigenous and non-indigenous Australians between 2003 to
2007.

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Additionally, data collected in the epidemiological research reveals that the is substantial
differences in the incidence of the disease concerning other aspects. The factors include age and
gender. The study conducted from 2007 to 2009 did not expose a constant age at which the
disease was more or less prevalent. However, it was established that the most significant
incidence lied beneath individuals of middle ages of twenty-five to forty-five years.
Correspondingly, the relative incident rate of the affected indigenous Australians ranged from
3.82 to 4.46 thus making an average of 4.12 (Excell, 2009). Moreover, the fixed rate was highly
characterized with associations in gender. It was clear that the female gender among the
indigenous population was the most affected with a relative incidence rate of 5.98. On the other
hand, the affected male individuals among the indigenous Australians have a relative incidence
rate of 3.01.
Moreover, another research conducted by McDonald (2013) implies that the relationship
between the incidence of end-stage renal disease and age revealed a great significance. The
relative incidence rate increased from 0.8 among indigenous Australians aged fifteen years old or
less to 14.8 among those aged forty-five to sixty-four years. Additionally, a decrease was noted
among indigenous Australians aged seventy-five years and above where the relative incidence
rate fell to 2.07 (McDonald, 2013). Still, the research did not reveal a significant difference in the
previous research on females. There were still lower rates of change among the infected female
indigenous Australians. It indicates that in any age bracket, the end-stage renal disease was
higher in females than in males. The study also proves that younger indigenous Australians are
still at a higher rate of attack than the older ones.
Another epidemiological research conducted by Chan et al. (2012) reveal the relationship
among the incidence, treatment and the geographical location of the indigenous Australians. It

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implied that higher rates of infection were more prevalent among indigenous populations
residing in more remote locations of Australia. Also, the study had a primary significance of
determining the credibility and accuracy of the epidemiological research. This care is influenced
by the distribution of the indigenous individuals in Australia. Moreover, statistics on the study
report reveal that seventy-eight percent of indigenous Australians thriving in remote regions have
to relocate to seek renal treatments in healthcare facilities (Chan et al., 2012). However, it is not
sure that variations in the geographical areas indicate prevalence differences in chronic comorbid
infections, access to treatment and progression in chronic kidney diseases. Moreover, the
reported cases of death from end-stage renal infections are rarely supported by the factor of
geographic variations since there is an insignificant difference of the issue between indigenous
Australians and the other individuals.
In reflection to the comorbid infections that occur at the same time with the end-stage
renal disorder, diabetic nephropathy is the predominant infection. The epidemiological
researchers imply that sixty percent of the indigenous population of Australia who is affected by
the end-stage renal disease suffer from diabetic nephropathy. The statistical were very significant
compared to twenty-five percent of non-indigenous Australians diagnosed with the two
comorbid infections at the same time (Tang et al., 2012). According to clinical interventions,
diabetic nephropathy is a primary causal agent of the end-stage renal disorder. Thus, the
diagnosis procedure carried out is similar where diabetic nephropathy symptoms indicate earlier
signs of the end-stage renal disease (Reutens, 2011). Therefore, it is essential for healthcare
providers to conduct further studies on the disease among the indigenous population to establish
proper preventive, curative and control measures of the disorder.

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As far as remoteness, age, gender, treatment procedures and comorbidity are concerned,
the people are also faced with challenges of poor infrastructure and poorer socioeconomic
indices as social determinants of health. Research reveals that the non-indigenous Australians are
more urbanized than the indigenous Australians. Therefore, it is relevant and authentic to imply
that the state of infrastructure concerning roads, schools, healthcare facilities, business
institutions and others is poor (Gracey, 2009). Hence, the indigenous population of Australia are
faced by a significant margin of poverty, where most of them cannot meet some basic needs such
as quality education, food, and healthcare services. Their poor social, economic statuses promote
some vices in the healthcare system such as healthcare disparities as much as nursing ethics are
concerned. Moreover, other factors such as poor roads minimize their capabilities of accessing
quality health facilities in Australia urban settings (White et al., 2010). Thus, this factor can
describe why there is still a high incidence and prevalence of the end-stage renal disease among
the indigenous population of Australia.
Correspondingly, education as a social determinant of health is another factor that can be
used in predicting the health situations among the indigenous Australians. The presence of low-
quality facilities that education in geographic regions dominated by indigenous populations leads
to poor education performances among them. Thus, few graduates manage to acquire
competitive professionals that generate quality service such as healthcare as well as income
(Marmot, 2011). This situation can explain the high incidence of end-stage disorder which
results from inadequate and insufficient infrastructure in healthcare facilities of Australia. The
case is also reinforced by high rates of chronic and comorbid diseases such as lung and heart
diseases experienced by the indigenous individuals in remote settings.

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Also, highly equipped doctors with knowledge and skills concentrate more on the private
sector than in the public sector. Hence, the public healthcare systems are dominated by nurses
who offer other healthcare duties under the instruction of the doctor and according to hierarchy
and power in healthcare institutions (Kuhlmann,2008). Moreover, limited information on proper
feeding habits as well as insufficient money to meet proper and recommended diets leads to
severe cases of diabetic nephropathy. Nevertheless, the condition is a primary promoter of the
end-stage renal disease which is more prevalent on the indigenous population of Australia than
the non-indigenous individuals.
Part B
The rate at which treatment is facilitated towards the end-stage renal disease increases
globally with time. Also, the increased prevalence and incidence of the disease among the
indigenous Australians establishes the need to analyze and re-examine the current treatment
strategies to increase treatment outcomes of the disease. Correspondingly, there is a need for
healthcare systems in Australia or different countries of the world to establish new strategies that
can address the situation at workplaces, community, state level and at the federal government
level (Vos et al., 2009). As revealed by epidemiological research reviews in part A, the current
strategies demonstrate a certain margin of failure in facilitating quality healthcare services which
are essential among most indigenous Australians, especially those residing in remote areas.
There is a crucial need to improve their socioeconomic status which includes the principal
determinants of health such as education, infrastructure, nutrition and others.
One of the fundamental strategies that can be applied to address the issue by organs in
different levels of the society is the implementation of high-quality healthcare and education
systems in regional and remote locations of the indigenous Australians (Braveman, 2011). This

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strategy will be essential in capacity building, collaboration, and sustainability of quality
healthcare and education services among the remote regions inhabited by indigenous Australians.
At the workplace, this strategy can be applied by sharing skills or educating fellow
workers on proper nutrition procedures. Feeding on a healthy diet is fundamental to avoiding
some nutrition-based infections such as obesity. The latter is known to be a primary causative
agent of diabetes which propels the occurrence of the end-stage renal disease. Moreover,
spreading information to illiterate and affected indigenous Australians on proper health facilities
which can offer adequate dialysis procedures can be crucial in prevention, treatment and
controlling the high incidence and prevalence of the disease (Mathew et al, 2010).
Correspondingly, it would be essential to advise fellow employees on how to collaborate non-
governmental and governmental organization to offer moral education and socioeconomic
support that would improve the wellbeing of indigenous Australians seeking quality education
and healthcare services in their remote regions of residence.
At the community level, the strategy can be used to address the end-stage renal disease
among indigenous Australians through drug and substance education procedures in association
with awareness on the disease before the symptoms become critical. The epidemiological
researchers conducted to reveal the indigenous Australians a highly associated with matters of
drug and substance abuse. Therefore, educating them on how to alter or change the situation
would save some funds used in drugs purchase for other essential uses such as teaching their
young children, providing means and access to high-quality healthcare institutions and other
factors (Mathew et al, 2010). Also, educating the middle-aged indigenous Australians on early
symptoms of the diseases would create self-awareness thus enabling them to seek quality
healthcare services once the first symptoms of the disease are experienced. Additionally, creating

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community committees that would address and forward issues affecting the indigenous
Australians to the state and federal authorities would assist the solve some critical problems such
as poor and inadequate healthcare and education systems.
Additionally, the federal and states have a critical role to play as far as matters of
implementing the strategy are concerned. The state government would assist in improving the
quality of healthcare and education systems in remote regions dominated by indigenous
Australians. The improvement mechanism includes improved means of transport and
accommodation at healthcare facilities which would enable infected indigenous Australians to
access the facilities easily before the condition is too severe to heal. On the other hand, the
federal government is responsible for funding, construction of quality infrastructures like roads
leading to remote areas, healthcare facilities and education systems (Ayodele, 2010).
Also, employment of skilled and enough workforce in the remote regions dominated by
indigenous Australians wound be essential providing high-quality healthcare services. Also,
collaborating with other non-governmental organizations would provide necessary aid to the
population. They include proper diet improve medication, adequate accommodation, and others
(Grol et al., 2013). Research implies that most of the indigenous Australians in remote regions
reside in temporary settlements which are unconducive as far as matters pertaining to their health
are concerned.
Successive application of the strategy at the mentioned levels would require social
support services. This procedure would begin with identifying individuals who are needy and
require the support either by relocating them to where dialysis provisions are available or
availing them to the remote regions. Therefore, there is an essential aspect of the collaboration of
state and federal governments, Aboriginal community controlled health organizations, NGOs,

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and general practice (Jha et al, 2013). Coordination among the organs would facilitate detection,
management, and prevention of the end-stage renal disease among other chronic infections. A
combined effort would reduce the high cases of tobacco and alcohol consumption reported
among the indigenous populations (Wilson, 2010). The activity causes the occurrence of chronic
conditions which are propelled by insufficient physical activities and poor nutrition.
Correspondingly, the mentioned groups can initiate local community campaigns aiming
at funding the indigenous populations in towards health and education promotion projects to
improve the living standards of the affected ethnic group. Also, the organs can offer to provide
the required necessities for screening and detecting the disorder as well as other chronic
infections to initiate new management procedures of the identified disease. It would also reduce
severe disease progressions and outcomes as well as high mortality and morbidity levels among
the indigenous Australians (Ludlow et al, 2011). Through collaborations, Medicare reforms can
be availed to the economically challenged groups to cater for additional expenses incurred during
treatment. Furthermore, the federal and state governments would ensure that the established
policies of the national health are implemented to provide quality Aboriginal Health Services
without charges. Also, the latter would ensure that the strategic health policy is altered to
accumulate new challenges emerging among the indigenous Australians.
Another fundamental aspect to consider while addressing the health situation is the
sustainability of the set strategy. Progress in healthcare and education systems would be
propelled and sustained if the mechanisms employed under effective care and consideration of
various factors. They include the social, environmental and economic factors in the field of
operation. These factors affect how efficiently and responsibly the allocated resources are
utilized and distributed among indigenous Australians to improve healthcare and education

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quality (Liaw et al, 2011). Moreover, the strategy becomes more sustained when the workforce
promotes health effectively, prevent and control the high incidence of end-stage renal disease
and offer quality education services to indigenous Australians in remote regions. Also,
establishing sustainable models and projects of care would increase the credibility of the
implemented strategies. In this case, sustainability is essential in ensuring equal distribution of
released funds and resources by the federal and state government and other non-governmental
organizations.
Moreover, sustainability of strategies is propelled by establishing plans that reveal
various challenges that are supposed to be solved. In this case, defining the health and education
challenges among the indigenous Australians would be essential in setting a long-term goal. The
social problems of inadequate health facilities and education system would assist in the
allocation of necessary resources that would increase the quality of education and healthcare
service provided to the indigenous Australians (Gruen et al., 2008). On the other hand, defining
environmental challenges such as poor settlement would aid in improving the quality of
settlement inhabited by the indigenous Australians. Correspondingly, identifying the financial
difficulties among individuals through poor diets, inability to meet healthcare expenses and low-
quality education would enable the relevant authorities to plan and meet the needs of the affected
individuals.
Capacity building is another primary aspect to consider as much as strategizing in
healthcare among indigenous Australians is concerned. It targets to improve sustainable health
activities and strategic processes. Moreover, capacity building is characterized by empowerment
and development of high cooperation levels among community individuals to yield a mutual
social benefit (Baillie et al., 2009). The latter extends to international aid development,

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community development, education and public health. These aspects are fundamental in
improving the sustainability of strategies set among the indigenous Australians in this case. It is
also associated with altering the policies regulating health and education systems, provision of
quality skills to the workforce, integration between organizations and community organizations.
These aspects aim at improving healthcare and education services among the indigenous
populations (Couzos, 2008).
In conclusion, this discussion sheds light on the significance of studying the end-stage
renal disease in indigenous populations in Australia. The increasing incidence and prevalence
among young and middle-aged Australians have revealed the need of taking the issue into critical
consideration. Also, a higher rate of comorbid disorders and the end-stage renal disease has been
observed among indigenous Australians than in the non-indigenous populations. Therefore, that
issue has established the need for developing a strategy that can control, prevent and treat the
condition to reduce the mortality rate and severe outcomes of treatment among the indigenous
Australians. The significance of creating strategies to address the situation at different levels of
the society has been revealed. Moreover, the federal and state government have a significant role
to play in improving the social determinants of health among the indigenous Australians.
Furthermore, the aspects of collaboration, sustainability, and capacity building have established
their importance in the strategic process of addressing the health situation among the indigenous
Australians.

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