UC Irvine

Continuity of care for End Stage Renal Disease (ESRD) patients is critical as they are at heightened risk for increased morbidity and mortality if their typically 3-times a week hemodialysis treatment is interrupted because of disaster-related disruptions in equipment, electricity, water, communication, or transportation.(1-4) For example, a month after Hurricane Katrina (2005), more than 50% of the dialysis facilities in Louisiana were still closed due to major damage caused by the hurricane.(5) These closures contributed to an increase in renal-related hospitalizations in the hurricane-affected areas.(6),(7) Similarly, during Hurricane Sandy (October 29, 2012), 306 dialysis facilities in New York and New Jersey were closed right after the hurricane struck.(2) Major disruptions in dialysis services caused by Sandy led to missed dialysis care during the first week post-Sandy for both U.S. Department of Veterans Affairs (VA) and non-VA patients. Major disruptions in dialysis services might have contributed to an increase in the 30-day mortality rate of 1.83% in Sandy-affected areas compared to 1.6% for the same month in the preceding year.(5, 8)