Descriptive Analysis of Undocumented Residents with ESRD in a Public Hospital System

OBJECTIVE: It is estimated that 6,000 undocumented residents in the United States require renal replacement therapy. In this work, we sought to evaluate the demographics of the patient population receiving hemodialysis in two Houston public hospitals and an affiliated clinic. METHODS: More than 186 undocumented residents receive dialysis in the Houston community. Demographic information was obtained via patient interview and chart review. Comparison was made with a matched cohort from the United States Renal Data System (USRDS) database, and statistical analysis was performed. RESULTS: Compared with patients in the USRDS, this patient population is younger and demonstrates lower prevalence of diabetes mellitus (42.6 versus 58.9 years; and 35% versus 68%, respectively; p < 0.01). More than 95% of the patients are Hispanic and only 23% graduated from high school. Most patients had spent more than 30% of their life in the United States before commencing dialysis. Only 3% of the patients had knowledge of their kidney disease prior to immigrating to the United States. DISCUSSION: The number of undocumented residents needing hemodialysis in the Houston public hospital system is large and imposes a significant financial burden on the community. Maintenance dialysis and expanded use of peritoneal dialysis are approaches that benefit these patients while containing costs. Adequate solutions require uniform policy nationwide.