Kidney Care in Rural Communities

National Rural Health Day on November 19 recognizes the health care professionals, organizations, and communities working to improve health across rural America.

For people living with kidney disease, access to care can involve much more than what happens during a medical appointment or kidney dialysis treatment. Patients may need to reach specialists, laboratories, pharmacies, kidney dialysis facilities, and other services on an ongoing basis. In rural communities, longer travel distances and fewer transportation options can add another layer of complexity.

Transportation is particularly significant for patients receiving in-center kidney hemodialysis, which generally requires treatment several times each week. Recent research has found that patients who rely on Medicaid transportation, paratransit, or public transportation are more likely to miss kidney dialysis treatments than patients with private transportation.

A 2026 study examining transportation challenges from the perspectives of both kidney dialysis patients and clinic staff also found that unreliable transportation can disrupt treatment, create stress for patients and staff, and interfere with clinic operations. Researchers emphasized the importance of collaboration among health care systems, transportation providers, and community organizations.

For rural patients, those challenges can be compounded by distance. Transportation may involve longer drives, limited public transit, fewer available drivers, changing weather conditions, and greater reliance on family members or caregivers.

Still, transportation is only one part of rural kidney care.

Home kidney dialysis is also becoming more common and may offer some patients greater flexibility by reducing the need to travel to a kidney dialysis facility several times each week. According to the U.S. Renal Data System, the percentage of patients using home kidney dialysis has increased over the past decade, and use is relatively high in rural areas of the Northwest.

Home kidney dialysis may not be appropriate or available for every patient. A person’s health, living situation, support needs, ability to manage treatment at home, and other factors can all affect whether it is appropriate. Patients interested in learning more should talk with their doctor and kidney care team about whether peritoneal dialysis or home hemodialysis may be an option for them.

Reliable rural kidney care also depends on strong local health systems, access to specialty care, telehealth when appropriate, pharmacies, laboratory services, and dependable transportation for patients who continue to receive care in person.

National Rural Health Day is an opportunity to recognize the people and organizations working to make those connections possible while continuing to strengthen access for patients across Oregon and Washington.