Background: Hemodialysis patients have faced unique challenges during the COVID-19 pandemic. They face high risk of death if infected, and have unavoidable exposure to others when they come to hospital three times weekly for their life-saving treatments. The objective of this study was to gain a better understanding of the scope and magnitude of the impacts of the pandemic on the lived experience of patients receiving in-center hemodialysis. Methods: We conducted semi-structured interviews with 22 patients who were undergoing dialysis treatments in five hemodialysis centers in Montreal from Nov 2020 to May 2021. Interviews were transcribed and then analyzed using thematic content analysis. Results: Most participants reported no negative impacts of the COVID-19 pandemic on their hemodialysis care. Several patients had negative feelings related to forced changes in their dialysis schedules, and this was especially pronounced for indigenous patients in a shared living situation. Some patients were concerned about contracting COVID-19, especially during public transportation, while others expressed confidence that the physical distancing and screening measures implemented at the hospital would protect them and their loved ones. Some participants reported that masks negatively impacted their interactions with healthcare workers, and for many others, the pandemic was associated with feelings of loneliness. Finally, some respondents reported some positive impacts of the pandemic, including use of telemedicine, and creating a sense of solidarity. Conclusion: Patients undergoing hemodialysis reported no negative impacts on their medical care, but faced significant disruptions in their routines and social interactions due to the COVID-19 pandemic. Nevertheless, they showed great resilience in their ability to adapt to the new reality of their hemodialysis treatments. We also show that studies focused on understanding the lived experiences of indigenous patients and patients from different ethnic backgrounds are needed in order reduce inequities in care during public health emergencies.

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Background. Kidney transplant recipients (KTRs) face numerous challenges following transplantation. Given that healthcare professionals do not necessarily have first-hand experience living with or waiting for a transplant, it may be hard for them to communicate with and help patients when it comes to transplant-related issues. KTRs have experiential knowledge, which could enable them to help other patients going through similar situations. Peer mentoring involves pairing mentees with individuals who have had similar experiences, to provide training, information, and emotional support. The aim of this study was to gather KTRs’ perspectives on a potential peer mentoring program. Methods. A total of 13 KTRs took part in focus groups between June 2017 and March 2018. The focus group discussions were digitally recorded and transcribed. The content of the interviews was analyzed using the qualitative data analysis method, including deductive and inductive coding techniques. Results. All participants were supportive of a peer mentoring program as it is a convenient and user-friendly way to address posttransplant concerns. Peer mentoring was also viewed as a way to communicate with other patients who have gone through similar experiences and relieve the loneliness and isolation some participants experienced subsequent to their transplant. Young female participants expressed a need to connect with other young, female transplant recipients to be able to discuss issues such as pregnancy, sexuality, and body image. Conclusions. KTRs who participated in this study expressed a need for the development of a peer mentoring program to help other KTRs face the medical (including cardiovascular disease), social, and psychological challenges associated with kidney transplantation. The results of this study are the first step in the development of a structured peer mentoring program at the kidney transplantation clinic.

Background Kidney transplantation is the best treatment for patients with end‐stage renal disease. The decision to accept a kidney from a deceased donor can be a difficult one, especially when organs from high KDPI (>85%) donors are offered. This study aims to capture the perspectives of transplant nephrologists (TNs) on the decision‐making process when an organ is offered. Methods Fifteen Canadian TNs took part in semi‐structured interviews between December 2017 and April 2018. The interviews were digitally recorded, transcribed, and analyzed using the thematic analysis method. Results The decision to accept a deceased‐donor kidney offer is a medical one for the participants. However, transplant candidates could be involved when the offered kidney is from a donor with a KDPI >85% or increased infectious risk donor. The TNs’ past experience, comprehensive data on the donor, and education of the transplant candidate could facilitate the decision‐making process. A decision aid could also facilitate the decision‐making process, but different concerns should be addressed. Conclusion Although accepting a deceased‐donor organ offer is often viewed as an opportunity for shared decision‐making, participants in this study viewed the decision to accept or refuse an offer as a medical decision with little room for patient participation.