LAUSR

BACKGROUND MĀori in New Zealand (NZ) are disproportionately affected by chronic kidney disease (CKD), and experience lower life expectancy on community dialysis compared to non-MĀori. We previously identified higher renal replacement therapy (RRT) requirement for MĀori in our intensive care unit (ICU), the tertiary referral centre for NZ's Te Manawa Taki region. AIM Describe mortality outcomes by ethnicity in the RRT-requiring population in our ICU. METHODS Retrospective audit of the Australia and NZ Intensive Care Society database for adult admissions to our general ICU from Te Manawa Taki between 2014-2018. Patients were stratified by non-RRT requirement (non-RRT), RRT-requiring acute kidney injury (AKI-RRT), and RRT-requiring end-stage renal disease (ESRD). RESULTS Relative to the Te Manawa Taki population, MĀori were over-represented across all strata, especially ESRD (61.8%), followed by AKI-RRT (35.0%), and non-RRT (32.4%) (p<0.001). There was no excess mortality by ethnicity in any stratum. Crude in-ICU mortality was similar by ethnicity amongst AKI-RRT (30.8% amongst MĀori, vs 31.5%, p=1.000), and ESRD (16.4% amongst MĀori, vs 20.6%, p=0.826). This trend remained at 1 year. Adjusted for clinically selected variables, neither AKI-RRT nor ESRD mortality was predicted by MĀori ethnicity, both in-ICU and at 1-year. Irrespective of ethnicity, AKI-RRT patients had highest in-ICU mortality (31.2%) (p<0.001), whilst ESRD had highest 1-year mortality (46.1%) (p<0.001). CONCLUSION Increased RRT requirement amongst MĀori in our ICU is due to higher representation amongst ESRD. We did not demonstrate excess mortality by ethnicity in any stratum. AKI-RRT had higher in-ICU mortality than ESRD, but this reversed at 1-year. This article is protected by copyright. All rights reserved.