KIDNEY DISEASE IN INCARCERATED TASMANIANS

S KUO1, C WAKE2, A GRAVER1, G KIRKLAND1, MD JOSE1,3, L JEFFS1

1Royal Hobart Hospital, Hobart, Tasmania; 2Tasmanian Prison Service, Tasmania; 3School of Medicine, University of Tasmania, Hobart, Tasmania

Aim: To determine the prevalence of chronic kidney disease (CKD) in incarcerated Tasmanians compared to the general Tasmanian population and to identify potential causes for discrepancy.

Background: The Australian Health Survey (2011-12) reported Tasmania to have the highest prevalence of CKD of all Australian states. In 2009, we published a report that found an increased number of severe CKD patients in lower socio-economic areas in Tasmania. The prison population is considered socially disadvantaged therefore should be at high risk for CKD, however, this has not been translated clinically.

Methods: A retrospective pilot study was performed with health data provided by the Tasmanian Prison Service on newly incarcerated prisoners (>18 years) over a 3 month period in 2011-2012. Creatinine and estimated glomerular filtration rate (eGFR) were obtained and compared to population data in Tasmania.

Results: Preliminary data over this time period identified 299 people newly incarcerated in Tasmania (87% male, mean age 41). 209 had creatinine and eGFR results, with 1.4% having eGFR <60 mL/min/1.73m2. This unadjusted figure is lower than reported by the Australian Health Survey  (4.6%,p=0.0033). Urine ACR was not performed during this time period. Potential contributors to this include lower prevalence of obesity (14.5% vs 27.8%, p=0.00011) and diabetes mellitus (3.7% vs 5.8%, p=0.14335) in the incarcerated population.

Conclusions: Preliminary, unadjusted data suggests there is a lower prevalence for CKD in incarcerated Tasmanians. Potential contributors include lower prevalence of diabetes and obesity. Further data will be obtained.

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