Rural patients with end-stage renal disease in Nebraska now face unprecedented access barriers as dialysis clinics close across underserved regions, forcing some to travel over 30 miles for essential treatment. This crisis affects hundreds of patients who depend on regular hemodialysis for survival. The closures reflect mounting pressures on outpatient nephrology services, driven by inadequate reimbursement rates, workforce shortages, and declining patient populations in rural areas. Extended travel distances pose significant health risks, including missed treatment sessions, medication non-adherence, and increased mortality rates among ESRD populations. Rural communities already struggle with limited healthcare infrastructure; the loss of dialysis facilities compounds existing disparities in chronic disease management. This data-driven crisis demands urgent policy intervention to stabilise rural nephrology networks and ensure equitable access to life-saving renal replacement therapy across all US regions.
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