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Immigration status and end‐stage kidney disease: Role of policy and access to care
Author(s) -
Rizzolo Katherine,
Cervantes Lilia
Publication year - 2020
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12919
Subject(s) - medicine , immigration , medicaid , dialysis , kidney disease , intensive care medicine , kidney transplantation , hemodialysis , end stage renal disease , health care , disease , end stage kidney disease , transplantation , economic growth , archaeology , economics , history
Immigration status is an important mitigating factor in determining the provision of dialysis and kidney‐related care. Immigrants make up the largest uninsured group in the country. For immigrants with end‐stage kidney disease (ESKD), dialysis access varies by insurance type and by state, leading to great variability in the availability of kidney care. In some states, undocumented immigrants may only qualify for hemodialysis when critically ill (emergency hemodialysis), which is associated with higher mortality, hospital length of stay, and cost, in addition to an emotional burden on patients, their caregivers, and healthcare professionals. Barriers to effective care for immigrants with ESKD include immigration status, insurance access, and availability of pre‐end stage kidney disease care, vascular access, and transplant. Effective strategies for improving dialysis care for immigrants include advocacy at the state and federal level, broadening definitions under Emergency Medicaid, and improving benefits for home therapies and transplantation options.