Three times a week, without exception, tens of thousands of Canadians must reach a machine that does what their kidneys cannot — and a McGill University study now reveals that two-thirds of those machines sit in the path of an intensifying fire. Researchers mapped 341 dialysis facilities against thirty years of wildfire records and found that the infrastructure sustaining life is increasingly entangled with the infrastructure of climate crisis. It is a collision not of bad luck but of long-deferred reckoning: the places where people settled, built hospitals, and grew ill are the same places no
Wildfires threaten dialysis care for two-thirds of Canadian patients, study finds
Approximately 23,000 Canadians receiving in-center hemodialysis face potential treatment disruption due to wildfire proximity and air quality degradation.
Two-thirds of dialysis patients depend on facilities in high-risk fire zones
Mark
So this study is saying that most Canadian dialysis patients live near wildfire risk. But how many of these facilities have actually been disrupted by fire?
Mimi
That's the thing—the study maps the risk, but it doesn't document widespread disruptions yet. It's a warning system, not a record of what's already happened.
Luke
Right. The study says 30 percent of facilities were within 5 kilometers of a recorded wildfire over thirty years. That's one facility in three. But proximity isn't the same as impact. We don't know how many patients actually lost access to treatment.
Mark
So this is predictive, not reactive.
Mimi
Exactly. The researchers are saying: look at where these facilities are, look at where fires have been and where fire danger is classified as high right now, and you can see the vulnerability before it becomes a crisis.
Luke
And the air quality piece is important too. Even if a facility doesn't burn, smoke can harm patients. But the study doesn't quantify that harm—it just flags it as a concern.
Mark
What would actually happen if a dialysis facility had to close for a week?
Mimi
Patients would need to find another facility, fast. If they can't, toxins build up in their blood. It becomes life-threatening quickly.
Luke
And in a major wildfire event, when multiple facilities might be affected at once, or when roads are closed, or when staff can't get to work—that's when the system breaks.
Mark
So the real question is whether Canada's health system has a backup plan.
Mimi
That's what the researchers are implying. They're saying emergency planners need to start thinking about this now, before the next big fire season.
Luke
The study doesn't say whether any such plans exist. That's the next reporting question.
Der Puls
- Approximately 23,000 Canadians face potential loss of life-sustaining dialysis treatment as 64% of facilities now sit in high or extreme wildfire risk zones.
- Dialysis tolerates no interruption — fire can sever electricity, contaminate water supplies, ground transportation, and drive trained staff away, collapsing the entire chain of care at once.
- Smoke compounds the danger beyond the flames themselves, further weakening patients whose health is already fragile and whose lungs and hearts bear the burden of kidney failure.
- Canada's 2023 wildfire season — the worst in recorded history at over 15 million hectares burned — signals not an anomaly but an accelerating pattern that health systems have not yet designed around.
- Researchers are now extending this risk-mapping method to floods, heat waves, and other climate hazards, arguing that merging climate science with medical infrastructure planning is no longer a choice but a survival imperative.
Three times a week, without exception, tens of thousands of Canadians must reach a machine that does what their kidneys cannot — and a McGill University study now reveals that two-thirds of those machines sit in the path of an intensifying fire. Researchers mapped 341 dialysis facilities against thirty years of wildfire records and found that the infrastructure sustaining life is increasingly entangled with the infrastructure of climate crisis. It is a collision not of bad luck but of long-deferred reckoning: the places where people settled, built hospitals, and grew ill are the same places now burning with greater frequency and force.
A dialysis patient cannot negotiate with time. Three or four times each week, they must reach a chair, a machine, clean water, and a trained clinician — or the toxins their kidneys can no longer clear will accumulate until the body fails. It was this unforgiving arithmetic that drove researchers at McGill University to ask a newly urgent question: where, exactly, do those machines sit in relation to wildfire?
The answer, published in Kidney International Reports, is unsettling. Mapping 341 dialysis facilities against three decades of wildfire records and current danger forecasts, the team found that 64 percent of Canadian facilities — serving roughly two-thirds of the country's 23,000 in-center hemodialysis patients — now occupy zones rated high, very high, or extreme wildfire risk. Nearly a third had already been within five kilometers of a recorded fire over the past thirty years.
The threat is not only the flame. Wildfire disrupts every link in dialysis care simultaneously: power lines fall, water supplies are contaminated, roads close, staff evacuate, and smoke degrades the health of patients who are already among the most medically vulnerable. Senior author Dr. Shaifali Sandal noted that any single broken thread can unravel the whole system.
The backdrop is a country whose wildfire seasons are growing measurably worse. In 2023, more than 15 million hectares burned — the most destructive season in Canadian recorded history — offering a glimpse of what intensification looks like in practice. The McGill team is now applying the same geographic risk-mapping approach to flooding, heat waves, and other climate stressors, making the broader argument plain: keeping people alive in a changing climate requires that medicine and climate science stop operating in separate rooms.
A patient on dialysis needs the same thing three or four times a week, without fail: a chair, a machine, electricity running through it, clean water flowing into it, and someone trained to manage it all. Miss one session and the poisons your kidneys can no longer filter start accumulating in your blood. Miss several and you die. This is the arithmetic that researchers at McGill University set out to map across Canada, overlaying the locations of 341 dialysis facilities against three decades of wildfire records and current fire danger forecasts. What they found is stark: nearly two-thirds of the roughly 23,000 Canadians receiving in-center hemodialysis depend on facilities situated in zones classified as high, very high, or extreme wildfire risk.
The study, published in Kidney International Reports, represents the first systematic assessment of its kind in Canada—an interdisciplinary effort that brought together specialists in medicine and geography to ask a question that climate change has made urgent: what happens to people whose survival depends on infrastructure when that infrastructure sits in the path of fire? Dr. Shaifali Sandal, an associate professor in McGill's Department of Medicine and senior author of the work, noted that dialysis is not a treatment that tolerates interruption. It requires not just equipment and electricity but also large volumes of clean water, trained staff, and reliable transportation for patients to reach the facility multiple times weekly. Any one of these threads breaking can unravel the whole system.
The numbers reveal the scope of the exposure. About 30 percent of the facilities studied had been located within five kilometers of at least one recorded wildfire over the past thirty years. But the more pressing figure is the current risk assessment: 64 percent of facilities now sit in areas where wildfire danger is classified as high or higher. These are not remote outliers. They serve the majority of Canadians who depend on dialysis to stay alive. The threat is not merely the fire itself. Poor air quality from smoke can further compromise patients whose health is already fragile, adding another layer of vulnerability to an already precarious situation.
Canada's wildfire seasons have grown more severe in recent years, a pattern that researchers attribute to climate change. In 2023 alone, more than 15 million hectares burned across the country—the worst wildfire season in recorded Canadian history. That year serves as a kind of preview of what the future may hold. The McGill team's work suggests that as these seasons intensify, the risk to dialysis patients will intensify with them, unless health systems and emergency planners begin to account for climate hazards in their infrastructure planning.
The researchers are now exploring how the same risk-mapping approach could be applied to other climate-related threats to healthcare delivery—heat waves, flooding, and other environmental stressors that can disrupt the systems patients depend on. The implication is clear: bridging climate science, geography, and medicine is no longer optional. It is becoming a requirement for keeping people alive.
Bemerkenswerte Zitate
Dialysis survival depends on complex community and health care system structures to deliver this therapy several times a week— Dr. Shaifali Sandal, McGill University
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