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May 30, 2023

Transportation woes remain a major issue for people who need in-centre dialysis

A new study highlights numerous challenges – whether it be physical, psychological or monetary – that Canadians face when travelling to hemodialysis centers.

Hemodialysis is a life-saving procedure for people experiencing kidney failure, but the vast majority of these patients must travel to a clinic 2-4 times each week to receive dialysis. For these individuals, suboptimal transportation arrangements are commonly cited as a source of ongoing stress and anxiety, and have been associated with a reduced quality of life and increased mortality risk.

Rachel Lewis and her colleagues sought to understand the impact of transportation to hemodialysis clinics in a Canadian population. They conducted an open forum with patients and family members, social workers, researchers and nurses. Nearly all patients reported feelings of frustration and anxiety, irrespective of their mode of transport to a dialysis clinic. Commonly cited issue include: the challenges of physically getting to the treatment center, particularly in adverse weather conditions; being a burden on family and friends; difficulties accessing the treatment facility; issues with public transport, including lack of reliability and poor flexibility with changes in hemodialysis treatment times; and financial worries related to high transportation costs.

In particular, Canadian weather conditions can make it challenging to travel to dialysis appointments, participants report. Most patients and staff could recall at least one occasion when storms prevented travel to or from dialysis, and some patients reported being stranded in their cars for several hours or even overnight when trying to return home from a dialysis centre.

Without a concerted effort to address these transportation challenges, it is likely that travel to and from dialysis will continue to adversely affect patients’ quality of life and willingness to continue treatment, the authors write.

Transportation Burden Associated With Hemodialysis in Canada: A Qualitative Study of Stakeholders

Lewis RA, Bohm C, Fraser F, Fraser R, Woytkiw L, Jurgutis S, Rubin M, Smith G, Buenafe J, Verdin N, Hutton J, Tonelli M

Kidney Medicine