Dialysis Crisis from Texas Ice Storm

Widespread power outages and water supply issues have created a dialysis crisis in Texas, following an onslaught of snow, ice, and sub-freezing temperatures.

“To say we’re stressed is an understatement. Almost all outpatient dialysis units closed due to power outages. Trying desperately to do as many as we can inpatient. To make matters worse some of our hospitals lost water today (so no HD [haemodialysis]). Truly a nightmare,” tweeted Tessa Novick, MD, a nephrologist at the University of Texas at Austin.
Half of Texas’ dialysis centres, serving 54 000 people, were unable to operate in the wake of the severe ice storm that has caused widespread damage in Texas and other parts of the US. Some patients had been without dialysis for four to five days, causing risk of potentially life-threatening potassium and fluid problems.

The large storm system, unofficially called Winter Storm Uri, dropped snow and ice over Texas on February 14 and 15, resulting in widespread power failures as lines were damaged. Few clinics have generators. Water pipes have also frozen, and this is a further problem as dialysis needs clean water to prepare concentrates and dialysate, and to reprocess the machines for following patients.

Fresenius Kidney Care said that around half of its Houston area centres have been impacted by a lack of water, “with the other centres either fully operational or operating on generators.” Water truck deliveries will allow other centres to reopen.

Tiffany Jones-Smith, CEO of the Texas Kidney Foundation, pointed out that there were some bright spots, such as eight clinics in San Antonio that brought water in and have been day and night to dialyse patients from any closed clinic regardless of affiliation. Other clinics were following suit, and Jones-Smith said patients were being given Uber and Lyft coupons to reach their dialysis centres. “We’re just kind of banding together and figuring out what needs to be done,” she said.

Looking ahead to when the crisis had cleared, Jones-Smith said, “We can’t let this go, because we need to be prepared for the next time, not just reacting to chaos, which is what we’re doing right now. … There’s no getting around we’ve had an epic failure.”

Climate change is predicted to increase the frequency and severity of such extreme events in the future, requiring better preparation.

Source: MedPage Today