Renal-related deaths in Indigenous people in Queensland, Australia.

Objective: Indigenous Australians have much higher mortality than non-Indigenous Australians. We aimed to quantify the excess of deaths with a renal causal assignment among Indigenous people aged 25 years and over in Queensland, Australia, 1997-2000 and their distribution by remoteness.

Methods: Both underlying and associated causes defined by ICD, 10(th) edition, were examined. Mortality rates were standardized to the concurrent non-Indigenous population.

Results: In Indigenous people, standardized mortality ratios with a renal assignment of death by remoteness of residence were 194% (Major City and Inner Regional), 439% (Outer Regional and Remote) and 782% (Very Remote). Of all these deaths with a renal assignment, only 18% had a renal assignment as the underlying cause. Diabetes and cardiovascular disease were frequent concomitant causes in deaths with a renal assignment.

Conclusions: The Indigenous population in Queensland has elevated rates of renal deaths compared with the non-Indigenous population. This disparity increases markedly with increasing remoteness of residence. Reliance on underlying causes of death alone greatly underestimates the association of renal disease with deaths in this population.