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Kidney Patient Care in Disasters: Lessons from the Hurricanes and Earthquake of 2005

Jeffrey B. Kopp^*, Lynda K. Ball, Andrew Cohen, Robert J. Kenney, Kenneth D. Lempert^||, Paul E. Miller^¶, Paul Muntner^**, Nauman Qureshi, and Sarah A. Yelton

^* Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; Northwest Renal Network (ESRD Network 16), Seattle, Washington; Department of Nephrology, Ochsner Clinic, New Orleans, Louisiana; Renal Associates of Baton Rouge, Baton Rouge, Louisiana; ^|| Nephrology Consultants of Northwest Ohio, Toledo, Ohio; ^¶ Miller Dialysis Acadiana Region, Ville Platte, Louisiana; ^** Department of Epidemiology, Tulane University, New Orleans, Louisiana; University of Alabama, Huntsville, Alabama; and Heartland Kidney Network (ESRD Network 12), Kansas City, Missouri

Correspondence: Dr. Jeffrey Kopp, Kidney Disease Section, NIDDK, 10 Center Drive, NIH, Bethesda, MD 20892-1268. Phone: 301-594-3403; Fax: 301-402-0014; E-mail: jbkopp{at}nih.gov

The active 2005 hurricane season alerted Americans to the pressing need for a more effective response to mass casualty incidents. The kidney patient community was particularly affected. Ninety-four dialysis facilities in the Gulf Coast states closed for at least 1 wk in the aftermath of Hurricane Katrina, and additional units were affected by evacuation of dialysis patients. Dialysis units along the Gulf Coast were also affected by Hurricanes Rita and Wilma. Existing emergency response plans were inadequate in providing continuity of care for kidney patients. The Kashmir, South Asia, earthquake of October 2005 killed 97,000 individuals. Building collapse was associated with widespread crush injury, and many patients required temporary hemodialysis. Several regions of the United States have the potential for catastrophic earthquakes. The Kidney Community Emergency Response Coalition has recently issued recommendations for patients, dialysis facilities, and providers, with a goal to improve care of kidney patients in future domestic disasters. With suitable planning, the nephrology community can do much to ensure the continuity of medical care for kidney patients in the face of a wide range of possible natural and human-made disasters.