End-stage renal disease, or ESRD, is a serious medical condition caused by failure of the kidneys that also has significant social and economic implications. The only treatments for end-stage renal disease are regular courses of dialysis or a kidney transplant. For individuals with ESRD who do not have access to treatment, either because they are uninsured or they may not be a legal residents of the U.S., often their only option is to resort to going to the emergency room in order to receive dialysis. However, mandatory hospital and even county protocols structured to prevent emergency room congestion can result in an individual seeking dialysis treatment being sent home if their medical status is not deemed life-threatening at that time. Unfortunately, these policies for the most part are ineffective at preventing ER congestion and also have the potential to negatively impact these patients’ health by delaying treatment. So is there a way to strike a balance between alleviating already strained emergency room resources while still providing life-saving care to vulnerable patients with very limited options? Joining me to discuss their research on this very topic are Sila Çetinkaya with Southern Methodist University and Olga Bountali with the University of Toronto.