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Objectives: To assess differences between Aboriginal and Torres Strait Islander and non‐Indigenous Australian children and young adults in access to and outcomes of kidney transplantation. Study design: A cohort study based on prospectively collected data; analysis of Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. Setting, participants: Children and young adults aged 0–24 years who commenced kidney replacement therapy in Australia during 1963–2020. Main outcome measures: Proportions of children and young adults who received kidney transplants within five years of commencing dialysis; 5‐ and 10‐year death‐censored graft survival; and 5‐ and 10‐year survival of children and young adults who received kidney transplants or who remained on dialysis. Results: During 1963–2020, 3736 children and young adults received kidney replacement therapy in Australia: 213 (5.8%) Aboriginal and Torres Strait Islander and 3523 (94.2%) non‐Indigenous children and young adults. During follow‐up (median, eight years; interquartile range [IQR], 2.6–15 years), 2762 children and young adults received kidney transplants: 93 Aboriginal and Torres Strait Islander (43.7% of those receiving kidney replacement therapy) and 2669 non‐Indigenous children and young adults (75.8%). Smaller proportions of Aboriginal and Torres Strait Islander than of non‐Indigenous children and young adults received transplants within five years of commencing dialysis (99, 46% v 2924, 83.0%), received living donor transplants (19, 20% v 1170, 43.9%), or underwent pre‐emptive transplantation (one, 1.1% v 363, 13.6%). Five‐year graft survival for Aboriginal and Torres Strait Islander recipients was similar to non‐Indigenous recipients (61% v 75%; adjusted hazard ratio [aHR], 1.43; 95% confidence interval [CI], 0.02–2.05), but 10‐year graft survival was lower (35% v 61%; aHR, 1.69; 95% CI, 1.25–2.28). Five‐ and 10‐year survival after kidney transplantation was similar for Aboriginal and Torres Strait Islander and non‐Indigenous people. Among those who remained on dialysis, 10‐year survival was poorer for Aboriginal and Torres Strait Islander than non‐Indigenous children and young adults (aHR, 1.50; 95% CI, 1.08–2.10). Conclusions: Five‐year graft and recipient survival were excellent for Aboriginal and Torres Strait Islander children and young adults who received kidney transplants; however, a lower proportion received transplants within five years of dialysis initiation, than non‐Indigenous children and young adults. Improving transplant access within five years of dialysis commencement should be a priority. [ABSTRACT FROM AUTHOR]

This article explores the significance of providing optimal care for Aboriginal and Torres Strait Islander peoples with kidney failure in the Northern Territory of Australia. It emphasizes the importance of addressing health disparities and cultural factors that influence health outcomes in order to improve the well-being of these communities. The article presents a case study of a Torres Strait Islander woman's health journey, highlighting the integration of traditional healing practices with biomedical approaches and the value of patient-centered care. Additionally, the article discusses the role of Storying, a method of knowledge collation and archiving in Aboriginal and Torres Strait Islander cultures, in amplifying marginalized voices and serving as an educational tool for healthcare providers and Indigenous individuals. The article underscores the significance of culturally sensitive care and patient autonomy in achieving positive health outcomes for Indigenous communities, and advocates for a model of care that prioritizes Indigenous self-determination, cultural safety, and acknowledges the social and cultural determinants of health. It also emphasizes the need for sustained support for Indigenous self-determination and the development of a diverse healthcare workforce to comprehensively address Indigenous health needs. [Extracted from the article]

The incidence of chronic kidney disease (CKD) is increasing worldwide. A holistic approach to management that includes nonpharmacological and pharmacological strategies to manage risk factors, as well as advocating for patients, particularly those most at risk, can significantly slow the progression of CKD. Input from multidisciplinary team members, including a nephrologist, CKD nurse and allied health professionals, can further reduce the progression of CKD, delay kidney failure and avoid CKD-related mortality. [ABSTRACT FROM AUTHOR]

The Medical Journal of Australia has partnered with the Lowitja Institute, Australia's national Aboriginal Community Controlled Research Institute, to release a special issue focused on Indigenous knowledges. The collaboration aims to address the lack of Indigenous perspectives in health research and publishing practices. The special issue features 12 articles that cover a range of topics related to Aboriginal and Torres Strait Islander health and wellbeing. The journal acknowledges the need to cede power and decision-making to Indigenous experts in order to improve ethical publishing practices and promote meaningful change in Indigenous health. [Extracted from the article]

The Zenadh Health Science Research and Education Council is being established as a physical infrastructure to unite Zenadh (Torres Strait) culture with Eurocentric sciences. The Council aims to secure and maximize Zenadh knowledge and skills while incorporating Eurocentric scientific practices. It is a means for Torres Strait Islander peoples to exercise their right to free, prior, and informed consent in scientific inquiry and to promote their political autonomy and self-determination. The Council will work on various health initiatives, such as providing haemodialysis services and reducing complications of diabetes. The authors emphasize the importance of cultural protocols and language in their work and express their desire for culturally honoring supporters and enablers of their survival. [Extracted from the article]