MedicalResearch.com Interview with:
Naoka Murakami MD PhD
Mount Sinai Beth Israel Department of Medicine
Medical Research: What is the background of the study? What are the main findings?
Dr. Murakami: Dialysis patients live in a complex sociomedical situation and are highly dependent on technologies to sustain their lives; such as transportation, electricity and water for the dialysis apparatus. Interruption of this infrastructure by a natural disaster can result in devastating outcomes.
During triage of patients arriving at Mount Sinai Beth Israel in the immediate aftermath of hurricane Sandy, we observed that many dialysis patients did not know about their medications, their comorbid conditions nor their dialysis prescriptions. Therefore we conducted a cross-sectional follow-up study of 357 hemodialysis patients in five dialysis units in lower Manhattan, New York. Using checklists prepared by the National Kidney Foundation and the Department of Homeland Security, we found that 26.3% subjects missed dialysis sessions and 66.1% received dialysis at non-regular dialysis unit(s). We observed that the distribution of a “Dialysis emergency packet” significantly improved retention of medical records at home. Analysis showed that dialysis-specific preparedness, racial ethnicity (non-African American, Hispanic or Caucasian), reception of dialysis in affiliated units, and older age, were associated with a significant reduction in missed dialyses.
Medical Research: What is the key conclusion?
Dr. Murakami: Hemodialysis patients are generally unprepared for natural disasters and there is a need to strengthen both patient and dialysis facility disease-awareness and preparedness to improve outcomes in natural disasters.
Medical Research: Are there additional impacts?
Dr. Murakami: Our survey showed a positive effect, for patients and providers, on being prepared of the distribution of a “Dialysis emergency packet”, (listing medication list, dialysis prescription, comorbid conditions and geographical/contact information for dialysis centers) and we propose that this be more conveniently located on a mobile electronic application.
2014 American Society of Nephrology abstract November 14 2014
Impact of Hurricane Sandy on Hemodialysis Patients and Preparedness for Natural Disasters,