64% of Canadian Dialysis Facilities Located in High or Extreme Wildfire Risk Zones

The McGill Medicine and Geography team overlaid national dialysis site coordinates with three decades of wildfire records and current fire danger indices. Thirty percent of sites lay within 5 km of at least one historical fire; under present conditions the high-risk share rises to 64%, placing roughly 15,000 patients in zones where power, water, and transport can be severed for days. The study is a static spatial risk assessment rather than a longitudinal outcomes analysis. Dialysis requires uninterrupted electricity, purified water, and twice-weekly travel. Wildfire seasons now routinely exceed 10 million hectares burned, amplifying concurrent threats from smoke-induced fluid overload and evacuation-related missed sessions. Earlier U.S. Medicare data after the 2017-2018 California fires documented 22% increases in missed treatments and 1.4-fold rises in emergency dialysis starts, patterns likely replicable in Canadian prairie and boreal corridors. The analysis flags the need for facility-level hardening and regional surge capacity but does not quantify intervention costs or patient-level mortality effects. Next steps include extending the GIS model to floods and heat waves plus prospective tracking of missed sessions during the 2027 fire season to convert exposure maps into preventable-event estimates.