Thread: THE ILLNESS EXPERIENCE OF UNDOCUMENTED IMMIGRANTS WITH END-STAGE RENAL DISEASE

The IllnessExperience of Undocumented Immigrants With End-stage Renal Disease.

Francisco is an undocumented immigrant who works as a landscaperand has been living in the U.S. for the last 35 years.

He regularly sees a physician and pays in cash for his clinics visits and medications; he was diagnosed with CKD 8 years ago, but now is approaching ESRD. His extended family (some ofthem living legally in the US) are potential living kidney donors and are willing to undergo testing.

Francisco does not want to give upand he wants to continue being productive and provide for his family. His clients have offered him monetary assistance . What are his options? Should we wait until he needs urgent hemodialysis? Should we provide a referral for dialysis, education, AVF or kidney transplant evaluation? Should Francisco return to his country of origin? Should he move to a more “undocumented people-friendly state”? Can he buy health insurance?

The Emergency Medical Treatment & Labor Act (EMTALA) was enacted in 1986 to “ensure public access to emergency services, regardless of ability to pay…”; however, the Patient Protection and Affordable Care Act(ACA, iaka Obamacare) does not include access to healthcare for undocumented immigrants.

A survey in 2009 among Nephrologists reported that 642 nephrologists (out of 990 who responded), have provided dialysis services to undocumented patients and 67% of those nephrologists did it as outpatient and 59% provided emergency dialysis care. The majority felt that reimbursement was inadequate.

Furthermore, there is a misconception that undocumented patients come to the U.S for health benefits; the latest literature reveals that in fact, undocumented immigrants contribute less to health care costs and use fewer medical services. Surprisingly, in a small survey in 2012among AJKD blog readers, close to 58% of respondents, did not support kidney transplantation.

Currently, in the United States there are approximately 6,500undocumented immigrants needing a form of renal replacement therapy, mainly hemodialysis. I am unaware of any data of patients undergoing peritoneal dialysis, which would be far more cost effective. These patients,depending on the state in which they live, have to either have insurance coverage to undergo scheduled hemodialysis or must wait to develop fluid overload symptoms in order to meet criteria to be admitted for emergency thermodialysis. The cost for receiving emergent hemodialysis ranges from $285,00 to 400,000 across the U.S.

This present qualitative study of 20 undocumented hemodialysis patients from Latin America, living in the US for at least 4.2 years, for the first time explored the feelings of undocumented patients undergoing urgent hemodialysis. According to this previous report, there areapproximately 6,500 undocumented immigrants on hemodialysis. This issueis not exclusive to the United States, but also to first world countries that receive large numbers of immigrants.

http://www.nephjc.com/news/2017/2/23/immigrant

Another cost the US taxpayer pick up the tab for. They can go waltz into any ER and get what they want.

ICE NEEDS TO GET AN OFFICER STATIONED AT THESE HOPSITALS THESE ILLEGAL GO TO!

Deport him and his undocumented family members. Let their country take care of his medical needs.

This is just the costs of kidney dialysis for 6,500 of them...probably thousands more since this article.

The costs of their TB and all the refugees who have been dumped on our backs cost US taxpayers $50,000 - $150,000 PER PERSON to treat!!!



PRESIDENT TRUMP...WE CANNOT AFFORD OUR OWN HEALTH CARE COSTS...WHY ARE YOU FORCING US TO PAY FOR THOSE WHO ARE NOT CITIZENS OF OUR COUNTRY!

EXTREME VETTING...NO HEALTH ISSUES THAT THE U.S. TAXPAYER HAVE TO FOOT THE BILL FOR!

DEPORT THEM ALL.

Something I can relate to since I am ESRD. I am also on, or was on, peritoneal dialysis. With peritoneal dialysis, I need virtually no assistance. I see a doctor once a month for a checkup. He reviews my blood test to see that my treatment is doing what it should. This is usually a five minute visit. I could pack my car up with the chemicals and go on a road trip.

So it would be cheap and feasible to send them back to their country, giving them supplies, or better, for their country to supply them.

I was, and for the near future, on hemodialysis. I had a "blowout", and had to stop peritoneal dialysis until I get surgery to put a "tire patch" on the leak.

When I switched to peritoneal dialysis, I discovered how Osama bin laden was able to survive on the run.

Hemodialysis requires a trained attendant. In clinic, I have a team of technicians and a nurse, in addition to expensive machines. It is inconvenient in that I have to go there three times a week, and sit in a chair hooked up to the machine for three hours. You can imagine how much more that costs than peritoneal dialysis which I do myself at home. It is also water intensive. My clinic runs about 10 of their 25 chairs, for two shifts a day, and runs over 7000 gallons of water per day. I can't wait for the California water rationing to kick in.

Sorry to hear this jtdc

Like I said...we have our own citizens to take care of the best we can.

We do not need to be burdened with giving FREE medical care to the entire world. They can go home and be cared for on their soil.

It is not our responsibility to pay for this nor our obligation to do so. It is THEIR countries obligation to take care of it's citizens.

We have the most expensive healthcare in the World all due to paying for foreigners who do not belong in this country and they pay nothing...now get them out of here!

American citizens see their healthcare costs rise every year, due in part to illegal aliens and their anchor kids not paying a dime for anything.

Blood pressure medicine treatments hurt your kidneys and causes a lot of these kidney-related problems we didn't used to have. If you can try to control your blood pressure with better diet and stay off the blood pressure meds as much as possible, it will help save your kidneys.

Originally Posted by Judy

Blood pressure medicine treatments hurt your kidneys and causes a lot of these kidney-related problems we didn't used to have. If you can try to control your blood pressure with better diet and stay off the blood pressure meds as much as possible, it will help save your kidneys.

Half of the people in my treatment center have diabetes, which is a major cause of kidney failure along with a host of other illness. Fortunately, I don't suffer from that. Although I had high blood pressure, that was not the cause of my kidney failure. Interestingly, the hospital put me on blood pressure pills. About three months after I got out of the hospital I asked my doctor to try other medication as I was fainting a lot, which was a side effect of the pills I was on. After looking at my pressure history, he took me off medication. In two days I was alert. I have been off them for about two and a half years and my blood pressure has actually stayed low. Some mornings I get up and measure it at 78 over 50. My doctor asked if I black out from that, but apparently my body has built a tolerance for that low pressure.

My kidneys may have started failing about five years ago. But I didn't have a doctor and ignored the symptoms until it was too late. I hurt. I virtually lost my vision. When I went in I thought it was a heart attack. It kind of was. I ran out of blood so my heart had nothing to pump. It was my body shutting down. Now I feel better than I have felt in at least five years.

Unfortunately, there are many such diseases from cardiac problems to cancer. Many are incurable, but treatable, at great cost.