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Safeguarding Patients with End-Stage Kidney Disease From Climate-driven Extreme Heat and Hurricanes

Published online by Cambridge University Press:  18 September 2024

Rebecca L. Shakour ,
Zain Mithani ,
Jeffrey B. Kopp ,
J. Marshall Shepherd ,
Leticia M. Nogueira Open the ORCID record for Leticia M. Nogueira [Opens in a new window] ,
Zelde Espinel  and
James M. Shultz
Rebecca L. Shakour
Affiliation:
University of Miami, Miller School of Medicine, Miami, Florida, USA
Zain Mithani
Affiliation:
Katz Family Division of Nephrology and Hypertension, University of Miami, Miller School of Medicine, USA
Jeffrey B. Kopp
Affiliation:
Kidney Disease Section, Center Drive, Bethesda, MD, USA
J. Marshall Shepherd
Affiliation:
UGA Atmospheric Sciences Program, University of Georgia, Athens, Georgia, USA Institute for Resilient Infrastructure Systems, Athens, Georgia, USA
Leticia M. Nogueira
Affiliation:
Health Services Research, American Cancer Society Inc., Chastain Meadows, Kennesaw, GA, USA
Zelde Espinel
Affiliation:
Department of Psychiatry and Behavioral Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida, USA
James M. Shultz*
Affiliation:
Protect and Promote Population Health in Complex Crises, DEEP Center, Center for Disaster and Extreme Event Preparedness, USA Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
*
Corresponding author: James M. Shultz; Email: jshultz1@med.miami.edu
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Abstract

5wPatients with end stage kidney disease (ESKD) who receive in-center hemodialysis are disproportionately vulnerable to extreme weather events, including hurricanes and heat waves, that may disrupt access to healthcare providers, and life-sustaining treatments. This current era of climate-driven compounding disasters is progressively elevating the level of threat to the health and well-being of patients with ESKD. This analysis brings together multi-disciplinary expertise to explore the contours of this increasingly complex risk landscape. Despite the challenges, important advances have been made for safeguarding this medically high-risk patient population. Hemodialysis services providers have devised innovative systems for preparing their patients and sustaining, or rapidly reestablishing, hemodialysis services in the aftermath of a disaster, and maintaining open lines of communication with their caseloads of ESKD patients throughout all phases of the event. A description of lessons learned along the path towards improved patient support in disasters, is provided. The article concludes with a detailed case example, describing dialysis providers’ effective response throughout Hurricane Ian’s passage across the State of Florida in 2022. Based on lessons learned, this analysis outlines strategies for protecting patients with ESKD that may be adapted for future climate-potentiated disaster scenarios.

Keywords

climate changeextreme heatend stage kidney diseasecompounding disastersMedically High-Risk PatientsHurricane Ian kidney Dialysis Providers
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e124
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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