Nav: Home

Illness experience of undocumented immigrants with end-stage renal failure

February 06, 2017

A small study of undocumented immigrants with kidney failure reports that not having access to scheduled hemodialysis results in physical and psychological distress that impacts them and their families, according to a new article published online by JAMA Internal Medicine.

About 11 million undocumented immigrants live and work in the United States but they are excluded from a range of public benefits, including Medicare, federally funded Medicaid and the insurance provisions of the Affordable Care Act. Hemodialysis is a life-sustaining treatment for patients with end-stage renal disease (ESRD). An estimated 6,480 undocumented immigrants in the United States have ESRD and some states use state emergency Medicaid programs to finance scheduled hemodialysis for these patients, while in most states these patients receive only emergency hemodialysis in emergency departments reimbursed by states' emergency Medicaid programs.

Lila Cervantes, M.D., of Denver Health, Colorado, and coauthors conducted an interview study with 20 undocumented immigrants (10 women and 10 men) at a Colorado safety-net hospital from July to December in 2015.

Patients described unpredictable access to emergency-only hemodialysis, the burden of symptoms (including shortness of breath as fluid builds up in the chest), and having to consume food or beverages high in potassium outside the hospital so they could meet the criteria of critical illness. Patients also reported having to miss work, anxiety over dying because of their life-threatening illness, and distress experienced by their families. Patients expressed appreciation for their care, although it was nonstandard and suboptimal, according to the article.

Limitations of the study include its small sample size from one safety-net hospital in Colorado.

"Undocumented patients with ESRD and no access to scheduled hemodialysis describe significant physical and psychological distress that affects their families and their own ability to work. This distress, coupled with higher costs for emergent dialysis, indicate that we should reconsider our professional and societal approach to ESRD care for undocumented patients. Comparing the experiences of different states and localities may aid in identifying more humane and higher-value solutions," the article concludes.
-end-
(JAMA Intern Med. Published online February 6, 2017. doi:10.1001/jamainternmed.2016.8865; available pre-embargo at the For The Media website.)

Editor's Note: The article contains funding/support disclosures. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Hemodialysis Articles:

New magnet technology creates easy blood access for hemodialysis patients
A new, minimally invasive system which uses radiofrequency energy instead of open surgery to create access for patients needing hemodialysis is reliable, with minimal complications, according to data published in the American Journal of Kidney Disease.
Illness experience of undocumented immigrants with end-stage renal failure
A small study of undocumented immigrants with kidney failure reports that not having access to scheduled hemodialysis results in physical and psychological distress that impacts them and their families, according to a new article published online by JAMA Internal Medicine.
Depression is under-treated in patients receiving chronic dialysis
A new study found that patients on chronic hemodialysis with depression are frequently not interested in modifying or initiating anti-depressant treatment.
Structure of kidney failure patients' blood clots may increase their risk of early death
Hemodialysis patients tend to have denser blood clots than individuals without kidney disease.
Study questions long-held belief related to hemodialysis care
In analyses of adults who initiated hemodialysis between 2004 and 2012, death rates in patients who had an arteriovenous fistula created prior to starting dialysis were lower than rates in patients who started dialysis using a catheter.
Scientists change properties of zeolites to improve hemodialysis
Scientists of Tomsk State University are working on changing physicochemical properties of zeolites using thermal and mechanical treatment.
The history of hemodialysis sheds light on the ethical use of limited medical resources
As medical research continues to generate new technologies and drugs for a wide variety of uses, questions arise regarding how such resources should be used and who should have access to them.
Nutritional vitamin D supplements do not help treat anemia in dialysis patients
Vitamin D2 supplements taken for six months did not reduce dialysis patients' need for anemia drugs that stimulate red blood cell production.
Can pomegranates reduce heart disease risk?
A new study assessing the antioxidant effects of pomegranate extract on cardiovascular risk factors and muscle function showed reductions in blood pressure and some atheroprotective benefits, but no effects on inflammation, oxidative strength, or muscle strength.
Kidney transplantation prolongs survival compared with home hemodialysis
Among kidney failure patients who were followed for five years, home hemodialysis patients were four times more likely to die than kidney transplant recipients.

Related Hemodialysis Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...