ESRD among Immigrants to Ontario, Canada: A Population-Based Study

Area of Science:

• Nephrology
• Epidemiology
• Public Health

Background:

• The prevalence and incidence of end-stage renal disease requiring maintenance dialysis (ESRD-D) among diverse immigrant populations remain understudied.
• Understanding these disparities is critical for public health initiatives and healthcare planning.

Purpose of the Study:

• To estimate the prevalence and incidence of ESRD-D among immigrants in Ontario, Canada.
• To identify specific immigrant groups at higher risk for ESRD-D.
• To inform the development of targeted kidney-protective interventions.

Main Methods:

• Utilized administrative health and immigration datasets to categorize Ontario residents in 2014 as immigrants or long-term Canadian residents.
• Calculated age-adjusted prevalence ratios (PRs) comparing ESRD-D rates between immigrants and long-term residents.
• Assessed age-adjusted ESRD-D incidence by immigrant origin (world region, country of birth) for those immigrating between 1991 and 2012.

Main Results:

• ESRD-D prevalence was higher in immigrants from sub-Saharan Africa (PR, 2.17), Latin America/Caribbean (PR, 2.11), South Asia (PR, 1.45), and East Asia/Pacific (PR, 1.34) compared to long-term residents.
• Immigrants from Somalia, Trinidad and Tobago, Jamaica, Sudan, and Guyana showed the highest ESRD-D prevalence ratios.
• Higher ESRD-D incidence was observed in immigrants from these regions relative to those from Western nations.

Conclusions:

• Immigrants from sub-Saharan Africa and the Caribbean exhibit the highest risk for ESRD-D in Canada.
• These findings underscore the need for tailored, kidney-protective interventions for high-risk immigrant populations.
• Public health strategies should address the specific needs of these vulnerable groups to mitigate ESRD-D.