Disaster management of chronic dialysis patients


  • Richard Zoraster, MD
  • Raymond Vanholder, MD, PhD
  • Mehmet S. Sever, MD




disaster, extrahospital care, dialysis, nondialytic management, end-stage renal disease


The chronically ill are often the hardest hit by dis-ruptions in the healthcare system—they may be highly dependent on medications or treatments that suddenly become unavailable, they are more physically fragile than the rest of the population, and for socioeconomic reasons they may be more limited in their ability to prepare or react. Medical professionals involved in dis-aster response should be prepared to care for individu-als suffering from the complications of chronic illness, and they must have some idea of how to do so with lim-ited resources.
Dialysis-dependent, end-stage renal disease patients are at especially high risk following disasters. Infrastructure damage may make dialysis impossible for days, and few physicians have experience or train-ing in the nondialytic management of end-stage renal disease. Nondialytic management strategies include dietary restrictions, aggressive attempts at potassium removal via resins and cathartics, and adaptations of acute treatment strategies. Appropriate planning and stockpiling of medications such as Kayexalate are crit-ical to minimizing morbidity and mortality

Author Biographies

Richard Zoraster, MD

Medical Director, National Hospital Preparedness Program, Disaster Division, Los Angeles County Emergency Medical Services Agency, Commerce, California.

Raymond Vanholder, MD, PhD

Chairman, Renal Disaster Relief Task Force, International Society of Nephrology; Departments of Nephrology and Internal Medicine, University Hospital, Gent, Belgium.

Mehmet S. Sever, MD

Turkish Coordinator, Renal Disaster Relief Task Force, International Society of Nephrology; Departments of Nephrology and nternal Medicine, stanbul School of Medicine, stanbul, Turkey.


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How to Cite

Zoraster, MD, R., R. Vanholder, MD, PhD, and M. S. Sever, MD. “Disaster Management of Chronic Dialysis Patients”. American Journal of Disaster Medicine, vol. 2, no. 2, Mar. 2007, pp. 96-106, doi:10.5055/ajdm.2007.0017.



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