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First Nations peoples are significantly more likely to experience kidney failure compared to non-Indigenous Australians. While they are six times more likely to be on dialysis treatment for kidney failure they are unfortunately much less likely to receive a kidney transplant.

About one in five First Nations peoples are living with signs of chronic kidney disease, which often hides alongside accompanying health conditions such as cardiovascular disease and diabetes. Twice the prevalence to non-Indigenous Australians.

“It’s a disease where there's no symptoms,” says Kidney Health Australia CEO Chris Forbes. “You can lose 90% of your kidney function and not have any idea – people are seemingly well one day and unwell the next resulting in a really late diagnosis.”

While two million Australians currently have kidney disease, mostly undiagnosed, First Nations peoples are more likely to be diagnosed at an earlier age, have poorer access to treatment, and experience worse overall health outcomes.

The problem is exacerbated by a range of factors. Almost one-third (32.4%) of Aboriginal and Torres Strait Islander patients reported racial discrimination in medical settings most or all the time, according to an Australian Institute of Health and Wellbeing national survey.

“It's a national shame,” Forbes says. “Central Australia has the highest rates of kidney failure anywhere in the world – that's completely unacceptable.”

Kidney Health Australia recently completed 4 years of work aiming to understand the needs and experiences of First Nations’ peoples with kidney disease. This culminated in the publication of the first ever guideline for Culturally Safe Kidney Care in First Nations Australians. Following on from this, in early 2024, Kidney Health Australia will release the 5th edition of the Chronic Kidney Disease Management in Primary Care handbook which will further cement these recommendations into GP practices across the country, helping to drive the detection and management of chronic kidney disease among First Nations peoples.

Factors associated with chronic kidney disease among First Nations Australians

Kidney Health

Source: Kidney Health Australia CARI guidelines.

But more needs to be done to end the crisis.

Kidney Health Australia’s objective is to work in partnership to create a transformational First Nations Kidney Health program, which will empower First Nations people to help build culturally appropriate, effective treatments.

It is well known that any such program must be Aboriginal led, responsive to the cultures of First Nations peoples, delivered on the ground by First Nations peoples, and then success evaluated through an Aboriginal lens.

“We can bring ideas and leadership and the clinical expertise around detection and management of kidney disease, but we have to partner to support the individual – who may also be living with diabetes, hypertension, rheumatic heart disease – and not just treat the kidney disease in isolation.”

There are challenges in treating kidney failure in First Nations population. Dialysis treatment is too often only available in cities and major rural centres, meaning that First Nations peoples often need to leave country to receive treatment, disconnecting them from community and culture. When it comes to kidney transplants – often considered the gold standard treatment – only 5.4% of kidney transplants performed in Australia are for First Nations recipients.

“Getting people back on country and remaining on country is so important to First Nations health outcomes, sense of community, culture, and overall wellbeing. We must get better equalities of care and transplants for First Nations peoples.

“Success will be about changing the paradigm, from kidney failure to kidney preservation. Getting more people diagnosed early, collaborating with communities to implement lifestyle changes and medications to slow disease progression – hopefully prolonging or avoiding the need for dialysis, and increasing access to kidney transplants– these are very visible benefits of us all coming together.”

Kidney Health Australia were the beneficiary of Equity Trustees' managed estates in 2016 and 2020.

If you are interested in learning more about how Kidney Health Australia is tackling the chronic kidney disease crisis, please reach out to Charney at or on 0432 422 192.


Banner image caption: Ashum Yarlupina Owen from Ngangki Warra (Ngangki Warra is a female led Kaurna women’s cultural group that aims to amplify women’s voices through culture, dance and language). Adelaide lawyer Ashum Owen, performed the welcome to country at Kanggawodli Aboriginal Hostel (Adelaide site) for the launch of the CARI Guidelines.