J Health Care Poor Underserved. 2025;36(4):1151-1158. doi: 10.1353/hpu.2025.a975578.
ABSTRACT
BACKGROUND: In the United States, uninsured patients with kidney failure often rely on emergency (compassionate) hemodialysis in acute care settings to manage life-threatening complications, as scheduled hemodialysis is often unattainable due to cost. This reactive approach has higher mortality rates, health care utilization, and cost than scheduled hemodialysis. Quality of life (QoL) outcomes are underexplored. This study evaluates changes in QoL after transitioning uninsured patients from emergency to scheduled hemodialysis.
METHODS: Kidney Dialysis Quality of Life (KDQOL) surveys were administered pre- and three-months post- transition at a federally qualified health center in Texas. A Wilcoxon signed-rank test analyzed score differences.
RESULTS: Among 39 patients significant improvements were observed across all KDQOL domains, with the greatest improvements in the “burden of kidney disease” (54.7%), “physical composite (33.13%), and “symptoms” (22.32%).
CONCLUSION: Expanding access to scheduled hemodialysis may improve QoL, reduce symptom burden, and lower cost in underserved populations.
PMID:41355634 | DOI:10.1353/hpu.2025.a975578
