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Compared with standard dialysis, providing emergency-only hemodialysis (EOHD) to undocumented immigrants with end-stage renal disease (ESRD) through emergency department (ED) visits is more costly and is associated with significantly higher short-term mortality. EOHD is covered by the Emergency Medical Treatment and Active Labor Act (EMTALA), can only be applied under select circumstances (i.e., when hyperkalemia, volume overload, and uremic symptoms are present), and is a departure from usual standards of care for ESRD patients. No national guidelines address EOHD, so protocols vary, with patients receiving tunneled catheters or permanent hemodialysis access and returning to the ED weekly or biweekly for evaluation and treatment. Little is…