ArticleJournal of nephrology2024
Geographic inequities in hemodialysis access: a call to reassess dialysis facility locations in Brazil.
Article in Journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Recommendations of the Brazilian Society of Nephrology for regulating access to outpatient dialysis in the Brazilian Unified Health System.Jornal brasileiro de nefrologia · 2026Guideline
- Position statement of the Brazilian Society of Nephrology on the refusal and discontinuation of dialysis.Jornal brasileiro de nefrologiaGuideline
- Maintenance of inequity in the provision of chronic dialysis treatment in Brazil.Jornal brasileiro de nefrologia · 2026Article
- Greenhouse Gas Emissions of Patient Transportation to Kidney Care - A Province-Level Retrospective Cohort Study.Canadian journal of kidney health and disease · 2026Article
- Registry of access to chronic dialysis initiation at the Public Health System in Brazil.International urology and nephrology · 2026Article
- A Decade of Change in Peritoneal Dialysis in Brazil: Challenges and Perspectives in the Public Health System.Healthcare (Basel, Switzerland) · 2025Article
- Standard of care for children and adolescents with chronic kidney disease and its Peculiarities: a call to action!Jornal brasileiro de nefrologiaArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients who travel more than 60 min to undergo hemodialysis may experience higher mortality and lower quality of life. The primary aim of this study was to calculate the travel distance between patient city areas and dialysis facility care locations in Brazil, to highlight barriers and need to optimize access to chronic dialysis.
methodsWe conducted a retrospective cohort study using claims data from the Brazilian Public Health System's database, focusing on kidney replacement therapy (KRT) by hemodialysis. Our study population comprised all patients undergoing hemodialysis in Brazil between January 2023 and December 2023. For patients from different city areas, we calculated the Haversine distance between the patient city area and the dialysis facility.
resultsWe evaluated 154,788 patients who received hemodialysis funded by the Brazilian Public Health System. Fifty-nine percent of the patients underwent dialysis in the same city area. Overall, patients traveled a median (IQR) distance of 35.9 [19.5 - 64.2] kilometers to the facilities, 48% traveled more than 40 km, with a maximum traveling distance of 353 km. Notably, the median distance traveled was shortest in the Southeast (27.6 km) and longest in the North (84.3 km). The number of patients that traveled more than 40 km was lower in the Southeast (32%) and higher in the North region (77%).
conclusionThe travel distance to the dialysis facility is an important inequity to KRT access in Brazil. In the South and Southeast, where there is a higher dialysis unit density, patients have greater regional availability of dialysis centers, and shorter traveling distances than in the North, Midwest, and Northeast regions.
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