Kidney Disease & Dialysis

“Homelessness increases the already formidable challenge of providing dialysis patients with adequate medical and nursing care. Hygiene, maintenance of medication regimens, dietary and fluid restrictions, emotional support, transportation, and compliance with treatment schedules are all made more difficult and complex by homelessness. As a result, these patients are more likely to experience ESRD [end-stage renal disease] complications, increased morbidity, and death. To compensate for the added burden imposed on their health by their social situation . . . and to bring about acceptable health outcomes for this population, a flexible, high functioning team is necessary.”

Holley JL, DeVore C, Obrero T, Noland L. (2006) Managing Homeless Dialysis Patients. Nephrology News & Issues, January.

Kidney Disease: Prevention & Early Detection of a Silent Killer (2010) | Kidney disease is one piece of a rampant triad undermining health around the world and in the United States. It is closely interrelated with hypertension and diabetes and like them is a silent disease, often remaining symptomless until there is massive damage. The articles included in this Healing Hands newsletter review relevant information about chronic kidney disease (CKD) and end-stage renal disease (ESRD), how to document client disability, and the role of medical respite in supporting clients affected by these conditions.

Managing Kidney Disease in the Homeless Population (2008) | This resource is workshop from the 2008 National HCH Conference & Policy Symposium presented by Jennifer Weil, MD, National Institute of Diabetes and Digestive and Kidney Disease, Phoenix, AZ.Participants will learn the common reasons homeless people develop chronic kidney disease (CKD) and how to screen for and stage CKD. Presenters discuss strategies for slowing CKD and touch briefly on dialysis treatment for homeless patients.

Hemodialysis and Homelessness: A Literature Review and a Call for Research (2000) | As the U.S. population ages, the number of persons with chronic conditions increases. Social isolation, declining health status, unemployment, and/or decreased income levels can all contribute to a forced change in residence. People on hemodialysis who are living in precarious housing situations are an under-recognized and silent population. Anecdotal evidence suggests that there is a larger population of hemodialysis patients living in various nontraditional situations than the literature reveals. This article describes both the homeless and chronic renal disease populations and demographic overlay, and issues a call for research.