Abstract：
BACKGROUND: The occurrence of Kidney Failure with Replacement Therapy (KFRT) amongst Irish Travellers has not been well described. This study aims to determine the burden of KFRT amongst the Irish Traveller population and identify determinants of health amongst this cohort which may differ from the general population in Ireland.
METHODS: This retrospective cohort study included self-identifying Irish Travellers with KFRT registered in the National Kidney Disease Clinical Patient Management System between 1995 and 2022. KFRT was defined as Chronic Kidney Disease stage 5 (CKD G5) treated by dialysis or CKD G1-G5 after transplantation. The primary outcome measure was the prevalence of KFRT in Irish Travellers. Secondary exploratory outcomes included age at diagnosis, family history, biopsy diagnosis, kidney replacement therapy (KRT) modality, time to initiation of KRT, primary vascular access used, and time to receive a kidney transplant.
RESULTS: Four of six Irish hospital groups participated in the study. A total of 38 patients were identified as Irish Travellers with KFRT, with a crude prevalence rate of KFRT of 0.12% (CI 0.084-0.161, 95%) or 11.9 per 10,000 Irish Travellers. The mean age for diagnosis of kidney disease was 43 (SD, 20.8) and at commencement of KRT was 45 (SD, 20.9) years. A biopsy-proven diagnosis was provided in 24%. Twenty-two per cent was diagnosed with polycystic kidney disease or congenital anomalies of the kidney and urinary tract. The predominant modality for KRT was haemodialysis (89%), with central venous catheters being the most common initial vascular access (79%). Kidney transplants occurred in 45% of those studied, with a mean waiting time of 1.96 (SD, 1.6) years.
CONCLUSIONS: The Irish Traveller community have similar prevalence of KFRT when compared to the national prevalence, with a short time interval from diagnosis to commencement of KRT. They are less likely to avail of home therapies but have comparable wait times to the national waiting time to receive a kidney transplant.
METHODS: This retrospective cohort study included self-identifying Irish Travellers with KFRT registered in the National Kidney Disease Clinical Patient Management System between 1995 and 2022. KFRT was defined as Chronic Kidney Disease stage 5 (CKD G5) treated by dialysis or CKD G1-G5 after transplantation. The primary outcome measure was the prevalence of KFRT in Irish Travellers. Secondary exploratory outcomes included age at diagnosis, family history, biopsy diagnosis, kidney replacement therapy (KRT) modality, time to initiation of KRT, primary vascular access used, and time to receive a kidney transplant.
RESULTS: Four of six Irish hospital groups participated in the study. A total of 38 patients were identified as Irish Travellers with KFRT, with a crude prevalence rate of KFRT of 0.12% (CI 0.084-0.161, 95%) or 11.9 per 10,000 Irish Travellers. The mean age for diagnosis of kidney disease was 43 (SD, 20.8) and at commencement of KRT was 45 (SD, 20.9) years. A biopsy-proven diagnosis was provided in 24%. Twenty-two per cent was diagnosed with polycystic kidney disease or congenital anomalies of the kidney and urinary tract. The predominant modality for KRT was haemodialysis (89%), with central venous catheters being the most common initial vascular access (79%). Kidney transplants occurred in 45% of those studied, with a mean waiting time of 1.96 (SD, 1.6) years.
CONCLUSIONS: The Irish Traveller community have similar prevalence of KFRT when compared to the national prevalence, with a short time interval from diagnosis to commencement of KRT. They are less likely to avail of home therapies but have comparable wait times to the national waiting time to receive a kidney transplant.
摘要：
背景：爱尔兰旅行者中替换治疗（KFRT）肾衰竭的发生尚未得到很好的描述。这项研究旨在确定爱尔兰旅行者人群中KFRT的负担，并确定该人群中健康的决定因素，这些因素可能与爱尔兰的普通人群不同。
方法：这项回顾性队列研究包括1995年至2022年在国家肾脏疾病临床患者管理系统中注册的自我识别的爱尔兰旅行者和KFRT。KFRT定义为移植后通过透析或CKDG1-G5治疗的慢性肾病5期(CKDG5)。主要结果指标是爱尔兰旅行者中KFRT的患病率。次要探索性结果包括诊断时的年龄，家族史,活检诊断,肾脏替代疗法（KRT）模式，开始KRT的时间，使用的主要血管通路，是时候接受肾脏移植了.
结果：六个爱尔兰医院组有四个参与了这项研究。共有38名患者被确定为KFRT的爱尔兰旅行者，KFRT的粗患病率为0.12％（CI0.084-0.161，95％）或每10,000爱尔兰旅客11.9。诊断为肾脏疾病的平均年龄为43岁（SD，20.8)，在KRT开始时为45(SD，20.9）年。24％的人提供了活检证实的诊断。22％的人被诊断患有多囊肾病或先天性肾脏和泌尿道异常。KRT的主要方式是血液透析（89%），中心静脉导管是最常见的初始血管通路（79％）。肾移植发生在45％的研究中，平均等待时间为1.96(SD，1.6）年。
结论：与全国患病率相比，爱尔兰旅行者社区的KFRT患病率相似，从诊断到开始KRT的时间间隔很短。他们不太可能使用家庭治疗，但等待时间与接受肾脏移植的国家等待时间相当。
方法：这项回顾性队列研究包括1995年至2022年在国家肾脏疾病临床患者管理系统中注册的自我识别的爱尔兰旅行者和KFRT。KFRT定义为移植后通过透析或CKDG1-G5治疗的慢性肾病5期(CKDG5)。主要结果指标是爱尔兰旅行者中KFRT的患病率。次要探索性结果包括诊断时的年龄，家族史,活检诊断,肾脏替代疗法（KRT）模式，开始KRT的时间，使用的主要血管通路，是时候接受肾脏移植了.
结果：六个爱尔兰医院组有四个参与了这项研究。共有38名患者被确定为KFRT的爱尔兰旅行者，KFRT的粗患病率为0.12％（CI0.084-0.161，95％）或每10,000爱尔兰旅客11.9。诊断为肾脏疾病的平均年龄为43岁（SD，20.8)，在KRT开始时为45(SD，20.9）年。24％的人提供了活检证实的诊断。22％的人被诊断患有多囊肾病或先天性肾脏和泌尿道异常。KRT的主要方式是血液透析（89%），中心静脉导管是最常见的初始血管通路（79％）。肾移植发生在45％的研究中，平均等待时间为1.96(SD，1.6）年。
结论：与全国患病率相比，爱尔兰旅行者社区的KFRT患病率相似，从诊断到开始KRT的时间间隔很短。他们不太可能使用家庭治疗，但等待时间与接受肾脏移植的国家等待时间相当。
