Background The epidemiology of ESRD requiring maintenance dialysis (ESRD-D) in large, diverse immigrant populations is unclear.

Methods We estimated ESRD-D prevalence and incidence among immigrants in Ontario, Canada. Adults residing in Ontario in 2014 were categorized as long-term Canadian residents or immigrants according to administrative health and immigration datasets. We determined ESRD-D prevalence among these adults and calculated age-adjusted prevalence ratios (PRs) comparing immigrants to long-term residents. Among those who immigrated to Ontario between 1991 and 2012, age-adjusted ESRD-D incidence was calculated by world region and country of birth, with immigrants from Western nations as the referent group.

Results Among 1,902,394 immigrants and 8,860,283 long-term residents, 1700 (0.09%) and 8909 (0.10%), respectively, presented with ESRD-D. Age-adjusted ESRD-D prevalence was higher among immigrants from sub-Saharan Africa (PR, 2.17; 95% confidence interval [95% CI], 1.84 to 2.57), Latin America and the Caribbean (PR, 2.11; 95% CI, 1.90 to 2.34), South Asia (PR, 1.45; 95% CI, 1.32 to 1.59), and East Asia and the Pacific (PR, 1.34; 95% CI, 1.22 to 1.46). Immigrants from Somalia (PR, 4.18; 95% CI, 3.11 to 5.61), Trinidad and Tobago (PR, 2.88; 95% CI, 2.23 to 3.73), Jamaica (PR, 2.88; 95% CI, 2.40 to 3.44), Sudan (PR, 2.84; 95% CI, 1.53 to 5.27), and Guyana (PR, 2.69; 95% CI, 2.19 to 3.29) had the highest age-adjusted ESRD-D PRs relative to long-term residents. Immigrants from these countries also exhibited higher age-adjusted ESKD-D incidence relative to Western Nations immigrants.

Conclusions Among immigrants in Canada, those from sub-Saharan Africa and the Caribbean have the highest ESRD-D risk. Tailored kidney-protective interventions should be developed for these susceptible populations.

背景技术尚不清楚在大量多样的移民人群中需要维持性透析（ESRD-D）的ESRD流行病学。

方法我们估算了加拿大安大略省移民中ESRD-D的患病率和发病率。根据行政健康和移民数据集，2014年在安大略省居住的成年人被归类为长期加拿大居民或移民。我们确定了这些成年人中的ESRD-D患病率，并计算了将移民与长期居民进行比较的经年龄调整的患病率（PRs）。在1991年至2012年期间移民到安大略省的那些人中，按世界地区和出生国计算了年龄调整后的ESRD-D发病率，其中西方国家的移民为对象。

结果在ESRD-D中，在1,902,394移民和8,860,283长期居民中，分别有1700（0.09％）和8909（0.10％）。来自撒哈拉以南非洲地区（PR，2.17； 95％置信区间[95％CI]，1.84至2.57），拉丁美洲和加勒比地区（PR，2.11； 95％CI， 1.90至2.34），南亚（PR，1.45; 95％CI，1.32至1.59）和东亚和太平洋地区（PR，1.34; 95％CI，1.22至1.46）。来自索马里（PR，4.18; 95％CI，3.11至5.61），特立尼达和多巴哥（PR，2.88; 95％CI，2.23至3.73），牙买加（PR，2.88; 95％CI，2.40至3.44），苏丹的移民（PR，2.84； 95％CI，1.53至5.27）和圭亚那（PR，2.69； 95％CI，2.19至3.29）相对于长期居民而言，年龄校正后的ESRD-D PR最高。

结论在加拿大的移民中，来自撒哈拉以南非洲和加勒比地区的移民的ESRD-D风险最高。应针对这些易感人群制定量身定制的肾脏保护性干预措施。