To the Editor We read with great interest the recent Original Investigation by Nguyen and colleagues.1 Emergency-only dialysis strategy is used to treat life-threatening manifestations of end-stage renal disease (ESRD) in undocumented immigrants with no access to scheduled dialysis without health insurance and is only used in France for the duration of a tourist visa (maximum, 90 days). This situation represents ethical dilemmas for clinicians and is common in Europe where immigrants represent about 1.5% of the dialysis population.2 This important study contributes to the management of undocumented immigrants with ESRD by reporting significant differences in health and economic outcomes in favor of a scheduled dialysis strategy. We further comment on the study design and method for the costs analysis, as well as their potential influence on the findings.
Godefroy R, Loubière S, Robert T. Comparison of Scheduled vs Emergency-Only Dialysis in Undocumented Immigrants With End-stage Renal Disease. JAMA Intern Med. 2019;179(5):728. doi:10.1001/jamainternmed.2019.0540
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