Renal disease and the environment: Lessons from Aboriginal Australia

Abstract

Aborigines in remote Australia are living in profound socio-economic disadvantage and epidemiological transition. They are also experiencing an epidemic of cardiovascular disease, with deaths increased >threefold and renal failure increased >20-fold. Dialysis costs pose a crisis, but premature death is the greater human catastrophe. In one high-risk group, we identified renal disease through the urinary albumin/creatinine ratio and assessed it distribution, its correlations, its associations with other morbidities and overall mortality and its natural history. We later introduced systematic antihypertensive and renal-protective treatment for afflicted persons. Albuminuria was detected in 55%..