Barriers to providing optimal dialysis care for undocumented immigrants: Policy challenges and solutions.

Barriers to providing optimal dialysis care for undocumented immigrants: Policy challenges and solutions. Semin Dial. 2020 Jan 07;: Authors: Welles CC, Cervantes L Abstract Access to hemodialysis for undocumented immigrants with end stage renal disease (ESRD) is widely variable across the United States and highly dependent upon state policy. Some states have enacted policies to provide coverage for standard dialysis to undocumented immigrants, while other states do not provide coverage. Patients living in some states which do not provide coverage rely on emergency federal coverage through the Emergency Medical Treatment and Active Labor Act. However, this act requires that patients present with an acute, life-threatening condition in order to receive dialysis, which is then referred to as "emergency-only hemodialysis" (EoHD). Because EoHD requires patients to present in life-threatening condition, patients who rely on EoHD suffer from debilitating physical symptoms and psychosocial distress. Undocumented immigrants who receive EoHD also have staggeringly higher mortality rates than those who receive standard hemodialysis. Moreover, in comparison with standard dialysis, EoHD results in greater health care utilization and higher health care costs. Therefore, EoHD represents a very low value care practice, providing substandard care at a greater cost. Policy change is urgently needed to provide undocumented immigrants with ESRD access to the stand...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research

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This study aimed to examine the association between the mode of dialysis or the values of sclerostin or DKK1 and carotid-femoral pulse wave velocity (cfPWV) in ESRD patients. There were 122 HD and 72 PD patients enrolled in this study. By a validated tonometry system, cfPWV was measured and then segregated patients into values of >10 m/s as the high central arterial stiffness (AS) group and values ≤ 10 m/s as the control group. Serum levels of sclerostin and DKK1 were measured using a commercial enzyme-linked immunosorbent assay kit. Possible risk factors for the development of AS were analyzed by logistic regres...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Conclusion: This is the first study to define 9-year mortality predictors in PD patients in our center. Although peritonitis is the most feared complication of PD, our study showed that peritonitis did not reduce patient survival. PMID: 32041385 [PubMed - as supplied by publisher]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
CONCLUSIONS: Physical activity levels, sedentary behavior levels, and muscle strength are related to physical function status for patients receiving dialysis. There is a need for robust longitudinal data to confirm the results of this investigation and for more focus on populations receiving peritoneal dialysis. PMID: 32045878 [PubMed - as supplied by publisher]
Source: Journal of Physical Activity and Health - Category: Sports Medicine Tags: J Phys Act Health Source Type: research
WEDNESDAY, Feb. 12, 2020 -- Peritoneal dialysis (PD) and in-center hemodialysis (HD) carry similar survival benefits, according to a review published online Jan. 28 in Nephrology Dialysis Transplantation. Mohamed E. Elsayed, M.B.B.S., from...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Publication date: Available online 10 February 2020Source: American Journal of Kidney DiseasesAuthor(s): Christopher T. Chan, Kelli Collins, Erich P. Ditschman, Lisa Koester-Wiedemann, Tonya L. Saffer, Eric Wallace, Michael V. RoccoHome dialysis modalities are used in a minority of patients with kidney failure in the United States. During the 2018 National Kidney Foundation–Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) Home Dialysis Conference, numerous ideas were suggested to help minimize barriers for the uptake and retention of home dialysis therapies. First, educational tools are needed to increase knowl...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
AbstractAimsMany heart transplant recipients will develop end ‐stage renal disease in the post‐operative course. The aim of this study was to identify the long‐term incidence of end‐stage renal disease, determine its risk factors, and investigate what subsequent therapy was associated with the best survival.Methods and resultsA retrospective, single ‐centre study was performed in all adult heart transplant patients from 1984 to 2016. Risk factors for end‐stage renal disease were analysed by means of multivariable regression analysis and survival by means of Kaplan–Meier. Of 685 heart transplant recipients...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
AbstractPurposeTo compare the economic burden and cost-utility analysis of the renal replacement therapies, including hemodialysis (HD), peritoneal dialysis (PD), and allograft kidney transplantation (KT) among end-stage renal disease (ESRD) patients from Yunnan Province, China.MethodsMultistage stratified random sampling method was used to select presentative sample of 298 patients from four hospitals in Yunnan Province. The two-step model was applied to calculate a direct economic burden; the human capital approach was used to analyze the indirect economic burden. SF-36 scale was applied to assess the quality of life, wh...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
In this study, the prevalence of carnitine deficiency and the clinical factors associated with carnitine deficiency were investigated in 60 patients undergoing PD. The median age of the patients was 62.5 years (52.5-72.5 years), the proportion of male sex was 44/60 (73.3%), and the median PD period was 24 months (12-45 months). Carnitine deficiency (acyl carnitine/free carnitine ratio>0.4) was detected in 56/60 (93%) patients. Multiple regression analysis showed that the erythropoietin resistance index was independently associated with carnitine deficiency (β = 0.283, p&thi...
Source: Renal Failure - Category: Urology & Nephrology Tags: Ren Fail Source Type: research
We examined a national cohort of incident end-stage renal disease patients that was comprised of 1,993 and 16,514 patients transitioning to HHD and PD, respectively, from 2007 to 2011. The HHD patients were matched with PD patients using propensity score (PS). Demographics, comorbidities, duration of dialysis, and body mass index were adjusted for in logistic regression models using PS matching. We matched 1,915 HHD patients with 1,915 PD patients based on the PS. The patients were categorized by their vintage (duration of dialysis) at the time of the transition to HHD or PD (
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
bet M Abstract Abdominal hernias are a frequent complication in peritoneal dialysis, representing up to 60.4% of anatomical complications. Their prevalence varies between 7 and 27.5%. Established risk factors are male gender, an older age, multiparity, a low body mass index and a paramedian approach for the catheter insertion. Polykystic renal disease and the intra-peritoneal volume are controversial risk factors. The diagnosis is mainly clinical, though peritoneography imaging can be useful in difficult cases. Hernia's complications, of strangulation, incarceration, bowel occlusion and peritonitis; can be very se...
Source: Nephrologie and Therapeutique - Category: Urology & Nephrology Authors: Tags: Nephrol Ther Source Type: research
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