Survey of dialysis therapy during the Great East Japan Earthquake Disaster and recommendations for dialysis therapy preparation in case of future disasters

The survey of dialysis therapy during the Great East Japan Earthquake Disaster (GEJED) highlighted the vulnerability of chronic dialysis therapy and dialysis patients to disasters. To minimize negative effects on patients on chronic maintenance dialysis during large-scale disasters that may occur in the future, it is important to promote the self-help efforts of dialysis facilities and to develop mutual assistance systems within local communities. Each dialysis facility has to take comprehensive disaster managements, including vibration control of large machinery, the use of flexible tubes, securing patient beds, and un-securing stand-type bedside consoles. Local governments should plan in advance how to support chronic dialysis therapy in their areas and how to assign roles among themselves when dealing with a large number of patients with acute kidney injury during long-term disruption of lifelines including electricity, water supply, and fuel. Dialysis patients are likely to develop cardiovascular events in times of disaster because of physical and psychological stress. Dialysis patients should understand in advance the key points of self-care in times of disaster and the availability of dialysis therapy in remote locations. It is also important to provide appropriate antihypertensive treatment to patients.