Incidence of end-stage renal disease in overseas-born, compared with Australian-born, non-indigenous Australians.
BACKGROUND
Barriers to immigration from non-European sources were relaxed in the 1970s. As a result, more Australians are now of Middle Eastern, Asian or Pacific Islander origin, rather than British or European. Currently, overseas-born persons comprise one-third of non-indigenous Australians with end-stage renal disease (ESRD).


METHODS
Using data recorded by the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, age-standardized incidence rates were calculated for ESRD due to all causes and to certain primary renal diseases for all non-indigenous Australians who were aged over 15 years when first treated for ESRD between 1993 and 2001. Truncated age-standardized incidence rates were calculated for ESRD due to glomerulonephritis by type.


RESULTS
Immigrants from the British Isles and 'rest of Europe' had less, and those from the Pacific Island nations, East/South-East Asia, Indian subcontinent, Middle East and Southern Europe more ESRD from all causes than the Australian-born. Two diseases accounted for most of the excess: Type 2 diabetic nephropathy and glomerulonephritis (the latter not significant for the Indian-born). There was a small excess (not always significant) of hypertensive/arteriopathic renal disease in Asian- and Middle Eastern-born persons. The East/South-East Asian-born had the highest rates of ESRD due to mesangial immunoglobulin A (IgA) disease and lupus nephritis, and the Middle Eastern-born the highest rates from focal sclerosing glomerulonephritis.


CONCLUSIONS
For Australians born in the Pacific Island nations, Asia, the Middle East or Southern Europe, excess prevalence of, and/or susceptibility to, diseases that cause ESRD has more than offset any 'healthy migrant' effect.
Stewart
John H
JH
Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia.
McCredie
Margaret R E
MR
McDonald
Stephen P
SP
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000208:ethnology; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005921:Glomerulonephritis / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D008297:Male; D008875:Middle Aged