Abstract: FR-PO864
ESKD Amongst Irish Travellers
Session Information
- Diversity and Equity in Kidney Health - II
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- O'Hara, Paul, Galway University Hospitals, Galway, Galway, Ireland
- Alzayer, Husam, Beaumont Hospital, Dublin, Dublin, Ireland
- Gorey, David, Galway University Hospitals, Galway, Galway, Ireland
- Mc Monagle, Edward Philip, University Hospital Limerick, Dooradoyle, Limerick, Ireland
- Madden, Michelle, University Hospital Waterford, Waterford, Waterford, Ireland
- Elhassan, Elhussein Aamir Elzein, Beaumont Hospital, Dublin, Dublin, Ireland
- Reddan, Donal N., Galway University Hospitals, Galway, Galway, Ireland
- Casserly, Liam F., University Hospital Limerick, Dooradoyle, Limerick, Ireland
- Leavey, Sean F., University Hospital Waterford, Waterford, Waterford, Ireland
- Conlon, Peter J., Beaumont Hospital, Dublin, Dublin, Ireland
Background
The occurrence of end stage kidney disease (ESKD) amongst Irish travellers has not been well described. This study will determine the burden of ESKD among the Irish Traveller population and identify determinants of health among this cohort which may differ from the general population.
Methods
This was a retrospective cohort study design involving any self-identifying Irish Travellers with ESKD registered in the National Kidney Disease Clinical Patient Management System between (1995-2021). ESKD was defined as a patient; with an eGFR <15ml/min/1.73m2, dialysis or transplant. The primary outcome was the prevalence of ESKD in Irish Travellers. Secondary exploratory outcomes were the age of diagnosis, family history or biopsy diagnosis, kidney replacement modality, time to initiation of kidney replacement therapy and the primary vascular access used, and time to receive a kidney transplant.
Results
Four hospital groups among six in Ireland participated in the study. A total of 38 patients were identified as Irish Travellers with ESKD with a crude prevalence rate of ESKD of 0.12% or 1.19 per 1,000 Irish travellers. The mean age for diagnosis of kidney disease was 43 (SD, 20.8) and commencement of kidney replacement therapy was 45 (SD, 20.9) years. A biopsy-proven diagnosis was provided in 24% of cases identified. Slightly more than one in five cases (22%) had a diagnosis of PKD or CAKUT. The predominant modality for kidney replacement therapy was hemodialysis (89%) with central venous catheters being the most common initial vascular access (72%). Kidney transplant occurred in 45% of those studied with a mean waiting time of 1.96 (SD, 1.6) years. The main mode of kidney transplant was cadaveric donation at 76%.
Conclusion
Allowing for small numbers and ascertainment bias; Irish Travellers are younger, have a higher prevalence of ESKD, and less likely to have a biopsy diagnosis than the prevalent ESKD general population. They tend to have a short time interval from diagnosis until commencement of kidney replacement therapy and a are less likely to benefit from home therapies but appear to be in line with the national waiting time to receive a kidney transplant. This data will help build a framework for policy development and practice enhancement in relation to kidney health in Irish Travellers.