{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Razon N"],"funding":["National Center for Advancing Translational Sciences","National Institute of Diabetes and Digestive and Kidney Diseases","Fresenius Medical Care North America","National Institutes of Health","GE Healthcare"],"pagination":["101199"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC12856434"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["8(2)"],"pubmed_abstract":["Rationale & objective
Transportation insecurity is a social risk factor of particular importance to individuals with end-stage kidney disease (ESKD), as most individuals need to travel multiple times a week to dialysis treatment. Advancing home modalities for individuals with ESKD experiencing transportation insecurity may be beneficial by reducing travel burden and improving access.Study design
Retrospective cohort study.Setting & participants
Individuals with ESKD treated with in-center hemodialysis (HD) at a large, national dialysis organization.Exposures
The main transportation mode to HD is categorized into private transportation (individuals who drive themselves or have a family member/friend drive) or those who lack private transportation (Medicaid non-emergency medical transportation, paratransit, public transportation, private pay non-emergency medical transportation, and other).Outcomes
Transition to home dialysis is defined as an individual who has completed at least 1 training treatment for home therapies or at least 1 dialysis treatment at home.Analytic approach
Log-binomial multivariate regression models to estimate adjusted incidence rate ratios of home dialysis transition by transportation mode.Results
Individuals who lacked private transportation were significantly less likely to transition to home dialysis compared with those who drove themselves or had a family member/friend drive them to HD. Adjusted incidence rate ratios for home dialysis transition were 47%-58% lower in nonprivate transportation groups compared with those with private transportation, ranging from 0.42 in individuals relying on Medicaid transportation benefits (95% confidence interval, 0.35-0.50; P < 0.001) to 0.53 (95% confidence interval, 0.41-0.67; P < 0.001) among paratransit users.Limitations
Single transportation assessment, exclusion of individuals already on home dialysis, and absence of caregiver data.Conclusions
Individuals with ESKD receiving in-center HD who lack private transportation may have reduced access to home dialysis, even though this group may benefit from home modalities. Better identifying transportation barriers and targeting home modalities for those with transportation insecurity may reduce the adverse consequences of missed dialysis related to transportation barriers and be an additional opportunity to increase home dialysis uptake."],"journal":["Kidney medicine"],"pubmed_title":["Association Between Transportation and Home Dialysis Transition: Retrospective Cohort Study."],"pmcid":["PMC12856434"],"funding_grant_id":["KL2 TR001859","UL1TR001860","K23 DK140602-01","1955-2025"],"pubmed_authors":["Dalrymple LS","Stennett AK","Zhang Y","Tancredi D","Fenton JJ","Razon N","Bonilla-Herrera B","Roshanravan B"],"additional_accession":[]},"is_claimable":false,"name":"Association Between Transportation and Home Dialysis Transition: Retrospective Cohort Study.","description":"Rationale & objective
Transportation insecurity is a social risk factor of particular importance to individuals with end-stage kidney disease (ESKD), as most individuals need to travel multiple times a week to dialysis treatment. Advancing home modalities for individuals with ESKD experiencing transportation insecurity may be beneficial by reducing travel burden and improving access.Study design
Retrospective cohort study.Setting & participants
Individuals with ESKD treated with in-center hemodialysis (HD) at a large, national dialysis organization.Exposures
The main transportation mode to HD is categorized into private transportation (individuals who drive themselves or have a family member/friend drive) or those who lack private transportation (Medicaid non-emergency medical transportation, paratransit, public transportation, private pay non-emergency medical transportation, and other).Outcomes
Transition to home dialysis is defined as an individual who has completed at least 1 training treatment for home therapies or at least 1 dialysis treatment at home.Analytic approach
Log-binomial multivariate regression models to estimate adjusted incidence rate ratios of home dialysis transition by transportation mode.Results
Individuals who lacked private transportation were significantly less likely to transition to home dialysis compared with those who drove themselves or had a family member/friend drive them to HD. Adjusted incidence rate ratios for home dialysis transition were 47%-58% lower in nonprivate transportation groups compared with those with private transportation, ranging from 0.42 in individuals relying on Medicaid transportation benefits (95% confidence interval, 0.35-0.50; P < 0.001) to 0.53 (95% confidence interval, 0.41-0.67; P < 0.001) among paratransit users.Limitations
Single transportation assessment, exclusion of individuals already on home dialysis, and absence of caregiver data.Conclusions
Individuals with ESKD receiving in-center HD who lack private transportation may have reduced access to home dialysis, even though this group may benefit from home modalities. Better identifying transportation barriers and targeting home modalities for those with transportation insecurity may reduce the adverse consequences of missed dialysis related to transportation barriers and be an additional opportunity to increase home dialysis uptake.","dates":{"release":"2026-01-01T00:00:00Z","publication":"2026 Feb","modification":"2026-06-19T04:46:02.417Z","creation":"2026-06-19T03:07:19.482Z"},"accession":"S-EPMC12856434","cross_references":{"pubmed":["41623305"],"doi":["10.1016/j.xkme.2025.101199"]}}