Global landscape of kidney health across Indigenous populations.

2025-10-16

Tungsanga, Somkanya

Okpechi, Ikechi G

Bianchi, Maria Eugenia V

Chaturvedi, Swasti

Collister, David

Crowshoe, Harley

Rodriguez de Sosa, Giselle M

Galadanci, Habibu A

Hedin, Erin

Ibrahim, Kwaifa S

Jain, Arsh K

Noronha, Irene L

Erickson, Robin L

Hughes , Jaquelyne

Komenda, Paul

Kulvichit, Win

Pecoits-Filho, Roberto

Raphael, Kalani L

Shah, Vallabh O

Tafuna'i, Malama

Tait, Caroline

Turner, Catherine

Walker, Curtis

Walker, Robert

Woods, Cathy

Levin, Adeera

Bello, Aminu K

Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Division of General Internal Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.

Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.

Argentine Northeast Kidney Foundation, Resistencia, Argentina.

Department of Nephrology, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Child and Maternal Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia.

Charles Darwin University, Darwin, Northern Territory, Australia.

Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Indigenous Health Program, Alberta Health Services, Edmonton, Alberta, Canada.

Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.

Department of Medicine, National Hospital, Abuja, Nigeria.

Division of Nephrology, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.

Nephrology Unit, Department of Medicine, Wuse District Hospital, Abuja, Nigeria.

Department of Internal Medicine, College of Health Sciences, Nile University, Federal Capital Territory, Abuja, Nigeria.

Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada.

Kidney Clinical Research Unit, London Health Sciences Centre, London, Ontario, Canada.

Renal Division, University of São Paulo Medical School, São Paulo, Brazil.

Paediatric Kidney Service, Starship Children's Hospital, University of Auckland, Auckland, New Zealand.

Rural and Remote Health, College of Medicine and Public Health, Flinders University, Nhulunbuy, Northern Territory, Australia.

Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia.

Royal Darwin Hospital, Northern Territory Department of Health, Darwin, Northern Territory, Australia.

Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada.

Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.

Arbor Research Collaborative for Health, Ann Arbor, MI, USA.

Medicine Section, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA.

Division of Nephrology & Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.

Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA.

Department of Biochemistry, School of Medicine, University of New Mexico, Albuquerque, NM, USA.

National Kidney Foundation of Samoa, Apia, Samoa.

Va'a o Tautai - Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand.

Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.

Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), Vancouver, Canada.

Department of Medicine, Midcentral District Health Board, Palmerston North, New Zealand.

Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD), Vancouver, Canada.

Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. aminu1@ualberta.ca.

Journal Article

Publication

0000-0002-2640-1131

0000-0002-6545-9715

0000-0002-2594-8602

0000-0002-7167-2619

0000-0002-1867-4156

0000-0002-4479-125X

0000-0002-3584-4057

0000-0003-3366-0956

0000-0003-2438-8401

0000-0002-6905-5937

Approximately 480 million individuals worldwide (~6% of the global population) are Indigenous peoples. Despite their diverse cultures and histories, the shared legacy of colonialism has profoundly shaped their health and socioeconomic status. This legacy is deeply intertwined with poverty, systemic racism and historical trauma, contributing to significant health disparities compared with non-Indigenous populations. Among the many chronic diseases disproportionately affecting Indigenous peoples, chronic kidney disease (CKD) stands out as a major public health concern. Indigenous peoples experience higher rates of CKD, yet they often face barriers to accessing responsive and culturally safe health-care services. Factors such as geographic isolation, socioeconomic disadvantages and systemic discrimination limit their access to preventive care, early disease detection and kidney replacement therapy, leading to worse health outcomes and higher mortality rates. Exposure to environmental and occupational risks and inadequate infrastructure further exacerbate CKD risk for Indigenous peoples. Here, we examine determinants of kidney disease and health among major Indigenous populations in Africa, Asia, Australia, Canada, Latin America, Aotearoa-New Zealand, the Pacific Islands and the USA. We discuss culturally safe and responsive strategies that can improve the delivery of kidney care and make policy recommendations for multiple levels of government to ensure health-care systems are equipped to meet the needs of Indigenous communities. By addressing these gaps and promoting cultural competence in kidney care, health-care providers can have a crucial role in reducing health disparities and improving Indigenous peoples' kidney health worldwide.

link

Nat Rev Nephrol . 2025 Oct 16. doi: 10.1038/s41581-025-01016-2. Online ahead of print.

1759-507X

https://pubmed.ncbi.nlm.nih.gov/41102463/?otool=iaurydwlib