Dialysis Without Borders
Authors: Ashwini R. Sehgal
Journal: Annals of Internal Medicine (2018)

Editorials17 July 2018Dialysis Without BordersAshwini R. Sehgal, MDAshwini R. Sehgal, MDCase Western Reserve University, Cleveland, Ohio (A.R.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1267 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail More than 700 000 persons in the United States have end-stage kidney disease (ESKD). Hemodialysis is the most common treatment (63% of patients) and is typically performed 3 times a week at an outpatient facility. Medicare covers virtually all citizens with ESKD, regardless of their age, and spends $34 billion on them annually (1).In contrast, an estimated 6500 undocumented immigrants with kidney failure in the United States lack reliable access to dialysis (2, 3). Some cities and states have developed funding strategies to provide regular hemodialysis (2, 3). However, undocumented immigrants in other regions must wait until they develop uremic ...References1. U.S. Renal Data System. 2017 Annual Data Report. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 2017. Accessed at www.usrds.org/adr.aspx on 6 May 2018. Google Scholar2. Raghavan R. Caring for undocumented immigrants with kidney disease. Am J Kidney Dis. 2018;71:488-494. [PMID: 29198642] doi:10.1053/j.ajkd.2017.09.011 CrossrefMedlineGoogle Scholar3. Rodriguez RA. Dialysis for undocumented immigrants in the United States. Adv Chronic Kidney Dis. 2015;22:60-5. [PMID: 25573514] doi:10.1053/j.ackd.2014.07.003 CrossrefMedlineGoogle Scholar4. Cervantes L, Tuot D, Raghavan R, Linas S, Zoucha J, Sweeney L, et al. Association of emergency-only vs standard hemodialysis with mortality and health care use among undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2018;178:188-195. [PMID: 29255898] doi:10.1001/jamainternmed.2017.7039 CrossrefMedlineGoogle Scholar5. Cervantes L, Fischer S, Berlinger N, Zabalaga M, Camacho C, Linas S, et al. The illness experience of undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2017;177:529-535. [PMID: 28166331] doi:10.1001/jamainternmed.2016.8865 CrossrefMedlineGoogle Scholar6. Zallman L, Wilson FA, Stimpson JP, Bearse A, Arsenault L, Dube B, et al. Unauthorized immigrants prolong the life of Medicare's trust fund. J Gen Intern Med. 2016;31:122-7. [PMID: 26084972] doi:10.1007/s11606-015-3418-z CrossrefMedlineGoogle Scholar7. Ziv TA, Lo B. Denial of care to illegal immigrants. Proposition 187 in California. N Engl J Med. 1995;332:1095-8. [PMID: 7898532] CrossrefMedlineGoogle Scholar8. Dwyer J. Illegal immigrants, health care, and social responsibility. Hastings Cent Rep. 2004;34:34-41. [PMID: 15098405] CrossrefMedlineGoogle Scholar9. Cervantes L, Richardson S, Raghavan R, Hou N, Hasnain-Wynia R, Wynia MK, et al. Clinicians' perspectives on providing emergency-only hemodialysis to undocumented immigrants. A qualitative study. Ann Intern Med. 2018;169:78-86. doi:10.7326/M18-0400 LinkGoogle Scholar10. Wolfe SM, Woolhandler S, Himmelstein DU. It is time to liberate hospitals from profit-centered care [Editorial]. J Gen Intern Med. 2018. [PMID: 29713883] doi:10.1007/s11606-018-4448-0 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Case Western Reserve University, Cleveland, Ohio (A.R.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1267.Corresponding Author: Ashwini R. Sehgal, MD, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109; e-mail, [email protected]edu.This article was published at Annals.org on 22 May 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinicians' Perspectives on Providing Emergency-Only Hemodialysis to Undocumented Immigrants Lilia Cervantes , Sara Richardson , Rajeev Raghavan , Nova Hou , Romana Hasnain-Wynia , Matthew K. Wynia , Catherine Kleiner , Michel Chonchol , and Allison Tong Metrics Cited byQualitative research methods and its application in nephrologyDialysis Without BordersEmil Lesho, DO, John Hix, MD, Melissa Bronstein, MPA, Shubha Shastry, MD, and Marvin Grieff, MD 17 July 2018Volume 169, Issue 2Page: 122-123KeywordsEnd stage kidney diseaseHealth careHealth insuranceMedical dialysisMedicareOutpatientsPatientsRenal failureResuscitationTaxes ePublished: 22 May 2018 Issue Published: 17 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...