April 8, 2026

Why in-person support still matters for rural patients doing dialysis at home

A recent study of rural patients doing peritoneal dialysis (PD) found that a heavy reliance on virtual care during the COVID-19 pandemic was associated with an increase in infections (peritonitis). The results highlight the importance of in-person care, not only to support safe dialysis techniques, but also to help patients feel comfortable being open with their care providers. 

Peritoneal dialysis (PD) is a useful option for people living with kidney failure in rural and remote areas, as it allows them to do dialysis at home. However, patients need training to self-administer PD safely and avoid infection in the abdomen—a condition called peritonitis.  

Between 2021 and 2023, health care workers in northern British Columbia noticed increasing rates of peritonitis among their patients, prompting UBC researcher and clinician Dr. Anurag Singh and colleagues to study why.  

They reviewed the health records of people who developed peritonitis and found three common themes. People who developed infections were more likely to have difficulty with sterile PD techniques, live in rural Indigenous communities, and receive a high portion of their care virtually, often by phone.  

Interviews with some patients revealed that many struggled to learn safe PD practices without hands-on training. Some felt unsure if they were performing their dialysis correctly or hesitant to ask for help. Others described feeling disconnected from their care teams.  

The findings highlight the value of a hybrid care approach—one that combines the accessibility of virtual check-ins with the hands-on support and relationship-building that in-person visits offer. For patients in rural and remote communities, this balance is important not only for safe PD, but also for building trust and supporting better outcomes, the authors emphasize.