Author: Nicholas Gray
Gray, Nicholas, 2025 Chronic kidney disease and selected domains of health equity (rurality, socioeconomic status, caregivers), Flinders University, College of Medicine and Public Health
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Chronic kidney disease is associated with poor quality of life, increased morbidity and mortality, and is expensive to treat, particularly when requiring dialysis or transplantation. It is strongly associated with health equity. This thesis includes 13 papers published between 2012 and 2022 in the equity domains of rurality, socioeconomic status, and caregivers.
The research included registry analyses, surveys, and clinical trials in Australia. Findings included a lower incidence and reduced survival with dialysis in rural areas, while telemedicine improved access to care with equivalent clinical outcomes. Socioeconomic disadvantage was associated with poorer dialysis survival, especially among younger people. Systematic reviews found significant caregiver burden and impact on quality of life whether kidney failure was managed with dialysis or conservative care, and a clinical trial found extended hours dialysis may exacerbate this impact.
This work confirms and extends international findings and highlights more work is required to improve health equity.
Keywords: chronic kidney disease, caregivers, carer, rural, socioeconomic, health equity, kidney
Subject: Medical Science thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Medicine and Public Health
Supervisor: Jonathan Craig