biostudies-literatureVerrelli DInstitut canadien d&apos;information sur la santéCanadian Institutes of Health Research101207https://www.ebi.ac.uk/biostudies/studies/S-EPMC12856449biostudies-literatureUnknown8(2)<h4>Rationale & objective</h4>During the coronavirus disease 2019 (COVID-19) pandemic, nephrology societies recommended transition from facility-based hemodialysis to home dialysis to minimize risks associated with COVID-19 infection. We compared transition rates from facility-based hemodialysis to home dialysis and rates and reasons for transfers from home dialysis to facility-based hemodialysis before and during the pandemic in Canada.<h4>Study design</h4>Interrupted time-series analysis.<h4>Setting & population</h4>Using administrative data from the Canadian Organ Replacement Register, our cohort included 31,596 and 22,607 adults with any time receiving hemodialysis during the prepandemic and pandemic study periods, respectively.<h4>Exposure</h4>Early pandemic (April 1, 2020-September 30, 2021) versus prepandemic (January 1, 2016-December 31, 2019).<h4>Outcomes</h4>Monthly rates of transitions between facility-based hemodialysis and home dialysis as well as reasons for transfer from home to facility.<h4>Analytical approach</h4>Segmented linear regression and analysis of covariance.<h4>Results</h4>During the early pandemic, transitions to home dialysis increased by 0.60 per 10,000 patients/month (95% CI, 0.08 to 1.11; <i>P</i> = 0.03), beyond the nonsignificant monthly prepandemic trend of 0.02 per 10,000 (95% CI, -0.10 to 0.13; <i>P</i> = 0.80). Monthly transfers from home dialysis to facility-based hemodialysis per 10,000 home dialysis patients also increased during the pandemic (6.91; 95% CI, 3.42 to 10.40; <i>P</i> < 0.001) versus the prepandemic period (-1.78; 95% CI, -4.31 to0.75; <i>P</i> = 0.20). The rate of increase in home-to-facility transfers during the pandemic was not significantly different than facility-to-home transfers (-0.10 transfers/month; 95% CI, -1.51 to 1.31; <i>P</i> = 0.89). More transfers to facility occurred for geographic/resource-related reasons during the pandemic versus prepandemic (5.8% vs 2.7%; <i>P</i> < 0.0001).<h4>Limitations</h4>Inability to analyze change in trends by province and ecological bias.<h4>Conclusions</h4>Transitions from facility-based hemodialysis to home dialysis increased, suggesting kidney care programs in Canada implemented recommendations intended to decrease COVID-19-related risks in this population. Reasons for the observed increase in transfers from home to facility during the pandemic are unclear.Kidney medicineHome Dialysis Transitions in Canada During the COVID-19 Pandemic: An Interrupted Time Series Analysis.PMC1285644920R26070Verrelli DTennankore KNickel NRigatto CBrar RFerguson THarasemiw OBohm CWhitlock RfalseHome Dialysis Transitions in Canada During the COVID-19 Pandemic: An Interrupted Time Series Analysis.<h4>Rationale & objective</h4>During the coronavirus disease 2019 (COVID-19) pandemic, nephrology societies recommended transition from facility-based hemodialysis to home dialysis to minimize risks associated with COVID-19 infection. We compared transition rates from facility-based hemodialysis to home dialysis and rates and reasons for transfers from home dialysis to facility-based hemodialysis before and during the pandemic in Canada.<h4>Study design</h4>Interrupted time-series analysis.<h4>Setting & population</h4>Using administrative data from the Canadian Organ Replacement Register, our cohort included 31,596 and 22,607 adults with any time receiving hemodialysis during the prepandemic and pandemic study periods, respectively.<h4>Exposure</h4>Early pandemic (April 1, 2020-September 30, 2021) versus prepandemic (January 1, 2016-December 31, 2019).<h4>Outcomes</h4>Monthly rates of transitions between facility-based hemodialysis and home dialysis as well as reasons for transfer from home to facility.<h4>Analytical approach</h4>Segmented linear regression and analysis of covariance.<h4>Results</h4>During the early pandemic, transitions to home dialysis increased by 0.60 per 10,000 patients/month (95% CI, 0.08 to 1.11; <i>P</i> = 0.03), beyond the nonsignificant monthly prepandemic trend of 0.02 per 10,000 (95% CI, -0.10 to 0.13; <i>P</i> = 0.80). Monthly transfers from home dialysis to facility-based hemodialysis per 10,000 home dialysis patients also increased during the pandemic (6.91; 95% CI, 3.42 to 10.40; <i>P</i> < 0.001) versus the prepandemic period (-1.78; 95% CI, -4.31 to0.75; <i>P</i> = 0.20). The rate of increase in home-to-facility transfers during the pandemic was not significantly different than facility-to-home transfers (-0.10 transfers/month; 95% CI, -1.51 to 1.31; <i>P</i> = 0.89). More transfers to facility occurred for geographic/resource-related reasons during the pandemic versus prepandemic (5.8% vs 2.7%; <i>P</i> < 0.0001).<h4>Limitations</h4>Inability to analyze change in trends by province and ecological bias.<h4>Conclusions</h4>Transitions from facility-based hemodialysis to home dialysis increased, suggesting kidney care programs in Canada implemented recommendations intended to decrease COVID-19-related risks in this population. Reasons for the observed increase in transfers from home to facility during the pandemic are unclear.2026-01-01T00:00:00Z2026 Feb2026-06-20T05:43:35.957Z2026-06-20T03:09:36.23ZS-EPMC128564494162329110.1016/j.xkme.2025.101207