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Early dialysis treatment improves health outcomes after natural disasters

Receiving dialysis treatment prior to regularly scheduled visits significantly lowered end-stage renal failure patients’ risk of ED visits and hospitalizations after Hurricane Sandy, compared with patients who did not receive advanced treatments, according to recently published data.

“This study confirms that early dialysis ahead of Hurricane Sandy’s landfall decreased the likelihood of ED visits, hospitalizations, and 30-day mortality for patients in the areas most affected. Such evidence affirms the importance of preparedness practices on the part of dialysis facilities to provide early dialysis, as well as the need for dialysis patients to receive early dialysis when access to routine dialysis may be threatened,” Nicole Lurie, MD, MSPH, HHS assistant secretary for preparedness and response, and colleagues wrote.

Using data from the CMS Datalink Project, researchers conducted a retrospective cohort study analyzing 13,836 patients receiving hemodialysis in New York City and New Jersey, to determine if early dialysis affected health outcomes after the hurricane.

Results demonstrated that 60% of participants received early dialysis. Patients who received early dialysis were significantly less likely to visit the ED (OR = 0.75; 95% CI, 0.63-0.89) or be hospitalized (OR = 0.77; 95% CI, 0.65-0.92) within one week of the storm, compared with patients’ who did not receive early dialysis.

Additionally, patients who had received early dialysis had lower mortality rates within 30 days of the storm (OR = 0.8; 95% CI, 0.58-1.09), compared with patients who did not receive early dialysis.

Lurie and colleagues noted that both dialysis centers and dialysis patients should play an active role in planning for natural disasters. Practices can prioritize and contact patients who may be most affected by a delay in dialysis, as well as install backup generators to lower the risk of power loss. Patients should also plan ahead and be aware of how to request advanced treatments in the case of emergency. 

“Every disaster holds the potential to impact health and often disproportionately affect people who are medically vulnerable, including people who require dialysis. This study provides the first evidence that reviving early dialysis in advance of potential disasters helps protect health and saves lives for dialysis patients and suggests that early dialysis should become a standard practice and protective measure,” Lurie said in a press release. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.