Table 3 Key issues in the management of undocumented-uninsured patients with CKD and ESRD in Israel
From: Care of undocumented-uninsured immigrants in a large urban dialysis unit
Remarks | Issue |
|---|---|
CKD therapy | Need for early referral to nephrology consultant (the ’Physicians for Human Rights’ clinic in Tel-Aviv, other healthcare service?) |
Main aim: delaying CKD progression towards ESRD | |
Dialysis therapy | Scheduled weekly hemodialysis therapy versus “emergent” dialysis therapy |
Hemodialysis versus peritoneal dialysis | |
Disparities of medical management (e.g. anemia, CKD mineral bone disease) | |
Lowering costs (e.g. machine monitoring of KT/V instead of blood samples) | |
Vascular access for hemodialysis | Disparities due to lack of reimbursement |
Creation of A-V access versus the use of TCC | |
Eligibility for clinical trials | Translation for informed consent |
Fear of exploitation | |
Continuity of therapy after termination of trial | |
Public health | Treatment of communicable diseases (e.g. tuberculosis) |
Renal transplantation | Access to kidney transplantation |
Reimbursement of medications post-transplantation | |
Legal | Lack of documentation and possible deportation |
Fear of deportation as a potential cause for skipped therapy | |
Avoiding return to country of origin if RRT is not accessible |