BACKGROUND: In most US states, taxpayers are paying, either directly or indirectly, for years of dialysis therapy for undocumented immigrants with end-stage renal disease who lack resources to pay for care themselves. Living donor transplant is a less expensive long-term alternative, but it is unknown what percentage of these patients have potential living donors. METHODS: We conducted a cross-sectional survey of undocumented immigrant patients receiving dialysis at our outpatient center between March and May 2010. Forty-five patients completed the survey. The survey focused on the availability of potential living donors, perceived health status of those donors, and potential recipients' outlook on remaining on dialysis therapy versus receiving a kidney transplant. We gathered demographic and health status data for the survey participants and the 82 documented resident patients receiving care in the same dialysis unit. RESULTS: The average age of our undocumented immigrant patients was 44 years. The undocumented patients were healthier than their legal resident counterparts, with a lower incidence of coronary artery disease (7% vs 33%; P < 0.005) and diabetes mellitus (40% vs 68%; P < 0.005). Approximately half the undocumented immigrants were working when they were surveyed. Of the half who had stopped working, 82% said they would seek work if they had a kidney transplant. 60% had at least one potential kidney donor. Most donors were reported to reside in the United States or Canada. CONCLUSIONS: Undocumented immigrants treated with dialysis in the United States are relatively young and healthy, and many have at least one potential living kidney donor. Given the societal cost-savings associated with transplant, we suggest that policy makers should consider extending coverage to pay for living donor transplant for undocumented immigrants with end-stage renal disease.
BACKGROUND: In most US states, taxpayers are paying, either directly or indirectly, for years of dialysis therapy for undocumented immigrants with end-stage renal disease who lack resources to pay for care themselves. Living donor transplant is a less expensive long-term alternative, but it is unknown what percentage of these patients have potential living donors. METHODS: We conducted a cross-sectional survey of undocumented immigrant patients receiving dialysis at our outpatient center between March and May 2010. Forty-five patients completed the survey. The survey focused on the availability of potential living donors, perceived health status of those donors, and potential recipients' outlook on remaining on dialysis therapy versus receiving a kidney transplant. We gathered demographic and health status data for the survey participants and the 82 documented resident patients receiving care in the same dialysis unit. RESULTS: The average age of our undocumented immigrant patients was 44 years. The undocumented patients were healthier than their legal resident counterparts, with a lower incidence of coronary artery disease (7% vs 33%; P < 0.005) and diabetes mellitus (40% vs 68%; P < 0.005). Approximately half the undocumented immigrants were working when they were surveyed. Of the half who had stopped working, 82% said they would seek work if they had a kidney transplant. 60% had at least one potential kidney donor. Most donors were reported to reside in the United States or Canada. CONCLUSIONS: Undocumented immigrants treated with dialysis in the United States are relatively young and healthy, and many have at least one potential living kidney donor. Given the societal cost-savings associated with transplant, we suggest that policy makers should consider extending coverage to pay for living donor transplant for undocumented immigrants with end-stage renal disease.
Authors: Lilia Cervantes; Delphine Tuot; Rajeev Raghavan; Stuart Linas; Jeff Zoucha; Lena Sweeney; Chandan Vangala; Madelyne Hull; Mario Camacho; Angela Keniston; Charles E McCulloch; Vanessa Grubbs; Jessica Kendrick; Neil R Powe Journal: JAMA Intern Med Date: 2018-02-01 Impact factor: 21.873
Authors: Jenny I Shen; Daniel Hercz; Lilly M Barba; Holly Wilhalme; Erik L Lum; Edmund Huang; Uttam Reddy; Leslie Salas; Sitaram Vangala; Keith C Norris Journal: Am J Kidney Dis Date: 2017-11-08 Impact factor: 11.072
Authors: S Jawad Sher; Waqas Aftab; Ranjani N Moorthi; Sharon M Moe; Christopher S Weaver; Frank C Messina; Nancy M Martinez-Hoover; Melissa D Anderson; Michael T Eadon Journal: Clin Nephrol Date: 2017-10 Impact factor: 0.975