Skip to main content Accessibility help

The Impact of a Large-Scale Power Outage on Hemodialysis Center Operations

  • Mahshid Abir (a1), Sophia Jan (a2), Lindsay Jubelt (a3), Raina M. Merchant (a4) and Nicole Lurie (a5)...



On June 29, 2012, mid-Atlantic storms resulted in a large-scale power outage affecting up to three million people across multiple (US) states. Hemodialysis centers are dependent on electricity to provide dialysis care to end-stage renal disease patients. The objective of this study was to determine how the power outage impacted operations in a sample of hemodialysis centers in the impacted regions.


The sample consisted of all hemodialysis centers located in the District of Columbia and a total of five counties with the largest power losses in West Virginia, Virginia, and Maryland. A semi-structured interview guide was developed, and the charge nurse or supervisor in each facility was interviewed. The survey questions addressed whether their centers lost power, if so, for how long, where their patients received dialysis, whether their centers had backup generators, and if so, whether they had any problems operating them, and whether their center received patients from other centers if they had power.


Calls were placed to 90 dialysis centers in the sampled areas and a 90% response rate was achieved. Overall, hemodialysis operations at approximately 30% (n = 24) of the centers queried were impacted by the power outage. Of the 36 centers that lost power, 31% (n = 11) referred their patients to other dialysis centers, 22% (n = 8) accommodated their patients during a later shift or on a different day; the rest of the centers either experienced brief power outages that did not affect operations or experienced a power outage on days that the center is usually closed. Some centers in the study cohort reported receiving patients from other centers for dialysis 33% (n = 27). Thirty-two percent (n = 26) of the centers queried had backup generators on site. Eleven percent (n = 4) of the centers experiencing power outages reported that backup generators were brought in by their parent companies.


Comprehensive emergency planning for dialysis centers should include provisions for having backup generators on site, having plans in place for the timely delivery of a generator during a power outage, or having predesignated backup dialysis centers for patients to receive dialysis during emergencies. Most dialysis centers surveyed in this study were able to sustain continuity of care by implementing such pre-existing emergency plans.

AbirM, JanS, JubeltL, MerchantR, LurieN. The Impact of a Large-Scale Power Outage on Hemodialysis Center Operations. Prehosp Disaster Med. 2013;28(6):1-4.


Corresponding author

Correspondence: Mahshid Abir, MD, MSc 310 Springloch Rd Silver Spring, MD 20904 USA E-mail or


Hide All
1.Zoraster, R, Vanholder, R, Sever, MS. Disaster management of chronic dialysis patients. Am J Disaster Med. 2007;2(2):96-106.
2.Abdel-Kader, K, Unrah, ML. Disaster and end-stage renal disease: targeting vulnerable patients for improved outcomes. Kidney Int. 2009;75(11):1131-1133.
4.Vanholder, RC, Van Biesen, WA, Sever, MS. Hurricane Katrina and chronic dialysis patients: better tidings than originally feared? Kidney Int. 2009;76(7):687-689.
5.Kleinpeter, MA. Disaster preparedness of dialysis patients for hurricanes Gustav and Ike 2008. Adv Perit Dial. 2009;25:62-67.
6.Vanholder, R, Van Biesen, WA, Lameire, N, Sever, MS. The role of the International Society of Nephrology/Renal Disaster Relief Task Force in the rescue of renal disaster victims. Contrib Nephrol. 2007;156:325-332.
7.Kutner, NG, Muntner, P, Huang, Y, et al. Effect of hurricane Katrina on the mortality of dialysis patients. Kidney Int. 2009;76(7):760-766.
8.Anderson, GB, Bell, ML. Lights out: impact of the August 2003 power outage on mortality in New York, NY. Epidemiology. 2012;23(2):189-193.
9.Broder, J, Mehrotra, A, Tintinalli, J. Injuries from the 2002 North Carolina ice storm, and strategies for prevention. Injury. 2005;36(1):21-26.
10.Daley, WR, Smith, A, Argandona, E, et al. An outbreak of carbon monoxide poisoning after a major ice storm in Maine. J Emerg Med. 2000;18(1):87-93.
11.Marx, MA, Rodriguez, CV, Greenko, J, et al. Diarrhea illness detected through syndromic surveillance after a mass power outage: New York City, August 2003. Am J Public Health. 2006;96(3):547-553.
12.Lin, S, Fletcher, BA, Luo, M, et al. Health impact in New York City during the Northeastern blackout of 2003. Public Health Rep. 2011;126(3):384-393.
13. New York Code Rules and Regulations (NYCRR), Title 10, Section 711.4. General structural, equipment and safety standards for existing hospitals, 10/14/98.
14. Standards for Health Care Facilities, NFPA 99. Quincy, National Fire Protection Association, 1996.
15. New York State Energy Research and Development Authority. The contribution of CHP to infrastructure resiliency in New York state. 2009. Accessed August 22, 2012.
16.New Jersey Department of Health and Senior Services. Standards for licensure of ambulatory care facilities. Accessed August 22, 2012.
17. Regulations governing the licensing and functioning of end stage renal disease units. Accessed August 22, 2012.
18.Tattersal, JE, Richards, NT, McMann, M, et al. Acute hemodialysis during the Armenian earthquake disaster. Injury. 1990;21(1):25-28.
19.Kleinpeter, MA. Disaster preparedness for dialysis patients. Clin J Am Soc Nephrol. 2011;6(10):2337-2339.
20. The Kidney Community Emergency Response Coalition Summit Report 2006. Accessed March 21, 2013.
21.Anderson, AH, Cohen, AJ, Kutner, NG, et al. Missed dialysis sessions and hospitalization in hemodialysis patients after hurricane Katrina. Kidney Int. 2009;75(11):1202-1208.
22. Centers for Medicaid and Medicare Conditions for Coverage: Governance Condition: Emergency Coverage. Accessed August 23, 2012.
23.Prezant, DJ, Clair, J, Belyaev, S, et al. Effects of the August 2003 blackout on the New York City healthcare delivery system: a lesson for disaster preparedness. Crit Care Med. 2005;33(1):S96-101.
24. A 90-day report: a review of the 2012 legislative session. Accessed August 22, 2012.


The Impact of a Large-Scale Power Outage on Hemodialysis Center Operations

  • Mahshid Abir (a1), Sophia Jan (a2), Lindsay Jubelt (a3), Raina M. Merchant (a4) and Nicole Lurie (a5)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed