ArticleClinical journal of the American Society of Nephrology : CJASN2025
Transportation Insecurity and Outcomes in Hemodialysis Patients: A Retrospective Cohort Study.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The trial behind it
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Who cites it
8 citing papers in PubMed.
- Improving Research on Transportation Interventions in Health Care.Health services research · 2026Article
- The impact of social determinants of health on acute kidney injury.Nature reviews. Nephrology · 2026Review
- Social Risk Factors and Kidney Transplant Waitlisting Among Patients Receiving Dialysis: A National Cohort Study.Kidney medicine · 2026Article
- "It's Part of Dialysis": Lived Experiences of Transportation Challenges Among Patients and Staff in In-Center Hemodialysis.The journal of nephrology social work · 2026Article
- Association Between Transportation and Home Dialysis Transition: Retrospective Cohort Study.Kidney medicine · 2026Article
- Emergency Department Utilization after Initiation of Intermittent Hemodialysis: A Retrospective Cohort Study in Regina, Saskatchewan.Canadian journal of kidney health and disease · 2026Article
- Pre-dialysis medical social worker support and survival in patients with kidney failure: impact on unplanned dialysis, hospitalization, and prognosis.Renal failure · 2025Article
- A Patient's Perspective on Transportation and Dialysis Outcomes.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundTransportation insecurity for people with end stage kidney disease (ESKD) treated with in-center hemodialysis (HD) may be a modifiable social risk that if addressed could improve access to dialysis treatments and lower mortality and complications associated with ESKD.
methodsRetrospective, national cohort study between April 1, 2022 through March 31, 2023. The study included all adults with ESKD receiving in-center HD within a large dialysis organization for at least 90 days prior to April 1, 2022 and having completed at least one transportation assessment. Primary outcomes were missed dialysis treatments and mortality. Primary exposure was the mode of transportation to dialysis.
resultsIn this study, 115,982 individuals (mean age 63 years, 43% female, 74% residing in urban setting) met the inclusion criteria. Nearly one-third (27%) did not have private transportation, defined as driving themselves or having a friend or family member drive them to dialysis. All individuals who lacked private transportation had higher mortality at one-year follow-up compared to those with private transportation: adjusted Incident Rate Ratio (aIRRs) (95%CI's) 1.25 (1.19-1.30), 1.21 (1.15-1.28), 1.70 (1.55-1.86), and 1.09 (1.02-1.17) for Medicaid, paratransit (available for individuals with a disability or a disabling health condition), private pay non-emergency medical transportation, and public transit, respectively. Medicaid, paratransit, and public transportation users were more likely to miss dialysis treatments compared to those with a private ride: aIRRs (95%CIs) 1.31 (1.27-1.35), 1.15 (1.11-1.20), and 1.24 (1.18-1.30), respectively. All non-private transportation users had higher likelihood of missed dialysis treatments attributed to transportation: aIRRs (95%CIs) 2.78 (2.62-2.94), 2.55 (2.35-2.76), 1.83 (1.58-2.12), and 2.73 (2.47-3.01) for Medicaid, paratransit, private pay non-emergency medical transportation, and public transit, respectively.
conclusionA lack of private transportation was associated with higher risk of missed dialysis treatments and mortality in adults with ESKD treated with in-center HD.
Identifiers
What OpenQuestion holds
Registered trials
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