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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
  1. Abbreviations: A-V, arteriovenous; CKD, chronic kidney disease; ESRD, end-stage renal disease; RRT, renal replacement therapy ; TCC, tunneled cuffed catheter.