RENAL-DISEASE IN THE AUSTRALIAN ABORIGINAL POPULATION - A PATHOLOGICAL-STUDY

End-stage renal failure and clinical evidence of renal disease are mor e frequent in Australian Aboriginals than in the non-Aboriginal Austra lian population. To investigate the lesions responsible for this exces s a systematic study of renal biopsy findings in a series of Aborigina l patients in South Australia and the Northern Territory was performed and the data on these patients were compared with a consecutive serie s of renal biopsy findings in non-Aboriginal patients. Histological an d morphometric comparison was made between biopsies from 206 Aborigina l and 690 non-Aboriginal patients. The distribution of glomerular lesi ons was found to differ significantly between the Aboriginal and non-A boriginal groups: diabetic glomerulosclerosis, idiopathic glomerular e nlargement (glomerulomegaly), mesangiocapillary glomerulonephritis (MC GN), and non-IgA mesangiopathic glomerulonephritis (GN) were found mor e frequently in the Aboriginal population, whereas there were fewer th an expected examples of thin membrane nephropathy, minimal change dise ase and membranous GN. Diabetic glomerulosclerosis was significantly m ure frequent, and the lesions more severe, in Central Australia (where diabetes is more prevalent) and glomerulomegaly was especially common in Bathurst Island. These two conditions accounted for one third of t he series and evidence is presented to suggest that a substantial prop ortion of renal disease in Aboriginals may be the consequence of conve rsion to a Western life style. Of the 206 Aboriginal patients, 23 pres ented with chronic renal failure, suggesting either late presentation or unusually aggressive renal lesions, and 10 had end-stage renal dise ase on biopsy.