October 23, 2017

A Canadian Perspective: Driving in End-Stage Renal disease on dialysis.

Are We Doing Enough For Driving Safety in Canadian Dialysis Patient?

Investigators: Dr. Bourne Auguste (1), Dr. Darren Yuen (1), Dr. Karthik Tennankore (2)
1. Division of Nephrology, University of Toronto, Toronto ON
2. Division of Nephrology, Dalhousie University, Halifax NS


Background & why is this study being done?

Driving is an essential daily activity for individuals requiring preserved cognitive faculties, particularly memory and concentration. Annually, it is estimated that motor vehicular collisions account for approximately 2,500 deaths and 180,000 injuries in Canada of which acute and chronic medical illnesses account for about 20% of cases *1. Although the evidence linking patients with end-stage renal disease (ESRD) to adverse events related to driving is limited, cognitive impairment is 2-7 times more prevalent in ESRD patients compared with the general population *2.

Cognitive impairment and inattention may result in a decreased ability to abide by traffic rules, more distractions and an overall decreased functional ability to perform driving tasks safely. With an increasing number of ESRD patients and over 20,000 patients on dialysis in Canada, there is a clear need for increased awareness of driving risk in this frail population, and a revisiting of recommendations for the clinicians who take care of them *3.

Cognitive impairment is a significant risk to drivers and many others who share the roads. The Canadian Council of Motor Transport Administrators (CCMTA) along with the Canadian Medical Association (CMA) have recommended that patients should not drive if a regular dialysis schedule is not maintained or therapy is delayed, although specific recommendations with respect to the assessment of cognitive dysfunction and driving safety have not been outlined to date *2, *4.

This survey will provide some insight into clinician awareness and current practices regarding driving safety in dialysis patients. Our ultimate goal is to provide a better foundation of data to inform more comprehensive strategies to ensure continued safety for patients and the general population.

1) Canadian Motor Vehicle Traffic Collision Statistics: 2010. Statistics Canada. 2010.
2) Canadian Council of Motor Transport Administrators: Determining Driver Fitness in Canada. 2015.
3) Collier, R. Number of Patients on Dialysis Increases 30%. CMAJ. 2017; 189: E292.
4) CMA Driver’s Guide: Determining Medical Fitness to Operate Motor Vehicles. 8th Edition. 2010

The link for the survey is here as well:

News Index