Southern Cross lecturer co-authors new national guidelines for First Nations Peoples with kidney disease

The inaugural Recommendations for Culturally Safe Kidney Care for First Nations Australians was published in October 2022 and is the culmination of a four-year project which involved extensive community consultation.

Southern Cross University lecturer in nursing for the Faculty of Health and Gnibi College of Indigenous Australians Dr Liz Rix co-authored the new national guidelines, drawing on her experience as a renal nurse.

“In the renal unit where I worked, there were nine dialysis chairs and, on every shift, three of those chairs would have Aboriginal people in them,” Dr Rix said.

“Once I started talking to patients about their care and their lack of ability to engage with a lot of the staff, I realised that we had to change the system.”

Dr Rix first flagged the need for guidelines for treating First Nations Australians with kidney disease while undertaking her PhD research, which later led to her being invited by Caring for Australians and New Zealanders with Kidney Impairment (CARI) to join the working group for writing the inaugural guidelines.

Dr Rix’s PhD research discovered that an absence of family and cultural considerations for Aboriginal people was a barrier to achieving better patient outcomes.

Kidney disease has been shown to disproportionately affect First Nations Australians. According to Kidney Health Australia and CARI, over 1.7 million adults living in Australia are affected by kidney disease. However, compared with the general population, First Nations Australians are twice as likely to develop kidney disease and nearly four times more likely to die with kidney disease. Furthermore, only 13 per cent of First Nations Australians with kidney failure patients receive a transplant compared to 51 per cent of non-Indigenous patients (ANZDATA Registry 2018).

First Nations Australians’ experiences of kidney disease and the national healthcare system were collated as part of the guideline writing process through Yarning-style community consultations held across the country over a two-year period.

“For me, it’s a true translation of research into practice,” Dr Rix said. “It’s so delightful to see community voice at the forefront and given full weight in the guidelines.”

“Some of the major themes from the community consultations were things like wanting to dialyse on Country. Another really important thing was more pre-disease screening and early diagnosis. Many Aboriginal people are showing signs of kidney disease as teenagers. So, the community want to see their children screened earlier.”

The new guidelines include recommendations to:

• Evaluate, monitor and act upon institutional racism within health services systems.
• Have First Nations Reference Groups advise kidney health services within Australia.
• Remove Indigenous status as a risk factor for chronic kidney disease.
• Provide healthcare staff with effective and responsive cultural safety training.
• Actively involve family and community of First Nations Australians with chronic kidney disease in all clinical appointments, according to individual preferences.
• Develop clear pathways for ensuring transport and accommodation needs are prioritised.
• Develop professional support for First Nations Australians with chronic kidney disease according to their needs, including use of interpreters and First Nations nurses, allied health professionals and doctors.

Dr Rix said she felt proud and privileged to have been a part of the writing process. “It’s been such a huge learning journey for me but also very validating of the years that I spent doing research,” she said.

“Now the hard work starts in disseminating the guidelines and urging clinicians across Australia to implement them.”

View the Recommendations for Culturally Safe Kidney Care for First Nations Australians.

Media contact: Southern Cross University media and content team, content@scu.edu.au