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Emergency-only hemodialysis yielded greater mortality rate in undocumented immigrants with ESRD
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Results published in JAMA Internal Medicine showed undocumented immigrants with end-stage renal disease had greater mortality rates and spent more days in the hospital when treated with emergency-only hemodialysis compared to treatment with standard hemodialysis.
Researchers compared 211 undocumented immigrants with end-stage renal disease treated with either emergency-only hemodialysis or standard hemodialysis at three separate hospitals between Jan. 1, 2007 and July 15, 2014. Researchers identified mortality as the primary outcome measure, and health care use and rates of bacteremia as secondary outcome measures.
Results showed hemodialysis was more likely to be initiated with an arteriovenous fistula or graft among patients who received standard hemodialysis. Researchers also noted higher albumin and hemoglobin levels were associated with patients who received standard hemodialysis compared with emergency-only hemodialysis.
After adjusting for propensity score, researchers found patients who received emergency-only hemodialysis had mean 3-year and 5-year relative hazards of mortality that were nearly five-fold and 14-fold greater, respectively, when compared with patients who received standard hemodialysis. Patients who received emergency-only hemodialysis had 9.81-times the expected number of acute care days and 0.31-times fewer ambulatory care visits than patients who received standard hemodialysis, according to results. –by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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