Border kidney patients who can't get local access to dialysis treatment are instead choosing to "let nature take its course" and dying, a top renal specialist says.
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Dialysis facilities at Wodonga - there are none at Albury hospital - haven't improved since 2012, said Russell Auwardt, a private nephrologist who refers patients to receive the vital treatment.
Dr Auwardt said most patients he referred to Wodonga hospital were put on a waiting list.
If they needed urgent treatment, Wangaratta was the nearest clinic with dialysis seats.
If that was fully booked, Melbourne was the only option, but many patients didn't have the means to travel there.
"Patients are choosing not to have dialysis and dying, rather than having to go to Wangaratta or Melbourne," Dr Auwardt said.
"Even going to Wangaratta is too much for some patients and they say, well, if I have to go to Wangaratta for dialysis, it's just too stressful, too difficult, I'm not going to have it.
"The thought of having to be transported three times a week to Wangaratta is just too much for them and they say, well, I'd rather have nothing and just let nature take its course."
Dr Auwardt was unsure of the numbers of patients who declined to receive the life-saving treatment but confirmed that "in the past five years, there's there's been difficulties accessing dialysis in Albury-Wodonga".
He said the increasing population of elderly people and kidney disease being more prevalent than 12 years ago was fuelling demand for the treatment.
In 2012, the waiting list for dialysis on the Border ended when a new $1 million treatment room opened at Wodonga hospital, lifting capacity to nine chairs for kidney patients to use, up from six.
Dr Auwardt at the time said he hoped the three extra chairs would cater for immediate future, but expected the ageing population, diabetes and high blood pressure to drive further demand.
"Nothing has changed since then," Dr Auwardt told The Border Mail on Monday, April 22.
Killawarra retiree Richard Shanley, who is not a patient who refused dialysis treatment and dropped off the waiting list, had been waiting five weeks to receive treatment for his kidney ailment at Wangaratta hospital.
Last Friday, Mr Shanley, who lives 8 kilometres north of Wangaratta, received a call from his specialist confirming he had a place, but was unsure whether this meant ongoing treatment or a one-off session.
The former architectural draftsman, 59, underwent a transplant operation in 1981, and was told five weeks ago he required urgent treatment when his kidney function dropped below 10 per cent.
"I got lucky, I suppose, in that I've just been told I can now get treatment but this lack of facilities needs to be known, how many other people are now on the waiting list like I was for five weeks?" Mr Shanley said.
"I was 17 when I had the first kidney, 21 when I had the second one, and from then on you're on medication for the rest of your life and under the guidance of a nephrologist."
When contacted by The Border Mail, Albury Wodonga Health forwarded the enquiry to the Victorian Department of Health.
Northeast Health Wangaratta said the hospital had seven chairs providing dialysis.
"The dialysis service at NHW operates as a satellite hub of Royal Melbourne, who manage referrals, treatment plans, and wait lists," a Northeast Health Wangaratta spokesman said.
"Activity for the dialysis service at NHW has been consistent over the past five years."
