An interview with Dr. Lilia Cervantes
The Centers for Disease Control and Prevention made it known that Hispanics are 35 percent more likely than non-Hispanics to develop end-stage renal disease. Add that statistic to the fact that there are more than 7,100 individuals with kidney failure in Colorado, and kidney disease awareness becomes a topic of discussion.
In order to bring kidney disease awareness and its prevention to the forefront, DaVita Kidney Care, a division of DaVita, Inc., utilized March 8th - World Kidney Day - to host a panel event at its world headquarters in Denver.
That panel event brought together some of the best minds and researchers in kidney health including representatives from the American Transplant Foundation, National Kidney Foundation, Denver Health and DaVita.
One of the panelists was Lilia Cervantes, M.D., who provides services at Denver Health and has done extensive research on Hispanics with kidney disease and their limited access to treatment.
“Marginalized groups such as Latinos and Blacks have worse health outcomes, even within Denver,” Dr. Cervantes said, in an exclusive interview with La Voz, as to why she began studying the connection between minority populations and kidney disease. “Those groups that have worse outcomes are also disproportionately burdened by social challenges.”
Looking at those social challenges, Cervantes came to the conclusion that her research was necessary to bring those differences to the attention of the public.
“Marginalized groups really need individualized care so they can overcome some of the barriers they face in the continuum of care that they face in end-stage kidney disease,” she said. “These patients have to come to dialysis three time per week. Sometimes they miss those appointments and sometimes their labs show that they aren’t eating what they are supposed to eat. It’s easy to stereotype these patients as not caring, but it takes a lot more effort to understand the context in which these things are happening.”
In order to understand that context, Dr. Cervantes said she had to look at the situation from the patient’s perspective.
“It could be the patient is facing housing insecurities, or that the patient’s primary care giver is facing deportation, or that the patient doesn’t have a refrigerator to store healthy foods, or doesn’t have access to healthy foods,” she said.
Cervantes said that in order to level the playing field with care for marginalized groups, treatment needs to be tapered to fit each patient’s needs.
“What’s important in terms of reducing health inequities and in improving the care of marginalized groups, is to provide care that is customized and individualized, and takes their entire narrative into account,” she said.
Another of her primary focuses has been on undocumented immigrants and the care - or lack thereof - they receive. Cervantes said that watching one of her undocumented patients at Denver Health pass away, was what helped her decide to delve into her research in the first place.
“What’s interesting is that in the country patients that are undocumented with end-stage renal disease do not have access to standard hemodialysis,” she said. “Anyone with failing kidneys will die, unless they receive dialysis three times a week.”
Dialysis is a machine that removes waste and extra fluid from the body in lieu of diseased kidneys that no longer have the ability to do so.
“For most people with end-stage renal disease this happens three times a week,” Dr. Cervantes said of dialysis treatment. “But for undocumented immigrants, they have to be critically ill before a hospital will offer emergency-only hemodialysis.”
After watching one of her patients, who could only receive emergency-only hemodialysis due to her migratory status, pass away, Dr. Cervantes decided to focus all of her work “on improving outcomes among Latino patients on dialysis.”
Her research led her to discover that undocumented patients that are allowed to receive dialysis treatment only on an emergency basis “suffer significant physical and psychosocial distress.
“These are patients that basically have near death experiences on a weekly basis,” she added.
During March, DaVita is raising awareness about chronic kidney disease and encouraging people to take a 60-second assessment online to help determine their risk of the the disease.