Dialysis Without Borders
Authors: Emil Lesho, John Hix, Melissa Bronstein, Shubha Shastry, Marvin Grieff
Journal: Annals of Internal Medicine (2018)

Letters18 December 2018Dialysis Without BordersEmil Lesho, DO, John Hix, MD, Melissa Bronstein, MPA, Shubha Shastry, MD, and Marvin Grieff, MDEmil Lesho, DORochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Search for more papers by this author, John Hix, MDRochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Search for more papers by this author, Melissa Bronstein, MPARochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Search for more papers by this author, Shubha Shastry, MDRochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Search for more papers by this author, and Marvin Grieff, MDRochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0524 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Cervantes and colleagues' timely article (1) and Sehgal's engaging editorial (2) highlight the increasing prevalence of end-stage kidney disease in the United States and discuss the many drawbacks of emergency-only hemodialysis, a negative result of human-made borders. One important and possibly underrecognized problem associated with emergency-only hemodialysis not mentioned is the ways in which urgent first-time or emergency dialysis can increase the risk for exposure to hepatitis B virus (HBV) faced by other patients concurrently receiving dialysis. Carriers of HBV must be dialyzed on dedicated equipment in a segregated setting, and providers must be aware of their ...References1. 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. [PMID: 29800062]. doi:10.7326/M18-0400 LinkGoogle Scholar2. Sehgal AR. Dialysis without borders. Ann Intern Med. 2018;169:122-3. [PMID: 29800021]. doi:10.7326/M18-1267 LinkGoogle Scholar3. University of California, San Francisco. The Kidney Project: statistics. 2018. Accessed at https://pharm.ucsf.edu/kidney/need/statisticson 10 August 2018. Google Scholar4. Liaw YF, Chu CM. Hepatitis B virus infection. Lancet. 2009;373:582-92. [PMID: 19217993] doi:10.1016/S0140-6736(09)60207-5 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Rochester Regional Health, Rochester, New York (E.L., J.H., M.B., S.S., M.G.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0524. 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 byMitigating and preventing hepatitis B virus exposures during hemodialysis across a large regional health system 18 December 2018Volume 169, Issue 12Page: 895KeywordsElectronic medical recordsEpidemiologyHealth careHealth surveysHepatitis B virusMedical dialysisPostexposure prophylaxisRenal failureResearch laboratoriesViral load ePublished: 18 December 2018 Issue Published: 18 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...