First Nations people in Canada are about half as likely to receive a kidney transplant as the general population, a new study finds.

The research was conducted over 10 years, following more than 4,000 adults who started dialysis in Alberta, Saskatchewan or Manitoba.

Aboriginal people had a significantly lower rate of kidney transplants than non-aboriginal Canadians, although survival rates for both groups are similar, the researchers reported in Tuesday's issue of the Canadian Medical Association Journal.

One of the study's authors, Dr. Marcello Tonelli, a kidney specialist at the University of Alberta in Edmonton, said the transplant rate findings come as a disappointment.

"I say disappointment because transplantation is the preferred treatment for kidney failure and we would like to ensure that that treatment is available to all," said Tonelli.

The reasons for the disparity aren't clear, but include the fact that many First Nations communities are far from major hospitals. This study was restricted to regions served by kidney transplant programs and rates did not vary between dialysis centres, which the authors say argues against geographic factors.

Other possibilities include a low organ donor rate and a high incidence of diabetes, which leads to a disproportionate rate of kidney failure.

The Assembly of First Nations calls the finding another example of unequal access to health care, arguing solutions must come from aboriginal communities.

"I think we need to focus more on prevention," said Bill Erasmus of the chiefs' committee on health for the AFN in Ottawa. "We need to look at how we can have healthier people."

Hundreds of aboriginal people are on dialysis as they wait for kidneys. There is one immediate solution, according to Tonelli.

"No matter where the barriers lie in the case of aboriginal people, if we can increase the rate of living donation we'll have an impact on the overall rate of transplantation," he said.

The study was funded by the Alberta Heritage Foundation for Medical Research, the Canadian Institutes of Health Research and the Kidney Foundation of Canada.

With files from CBC Health and Science

Links related to this story:

CANADIAN MEDICAL ASSOCIATION JOURNAL: Kidney transplant study

FROM SEPT. 13, 2004: Aboriginal heath care front and centre at summit