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Kidney360 ; 2023 Jan 10.
Article in English | MEDLINE | ID: covidwho-2241066


Access to care for patients with end-stage kidney disease (ESKD) is frequently disrupted following natural disasters, public health crises, and human conflict. Emergency preparation can mitigate the risk of harm and improve outcomes. Prior to Hurricane Katrina in 2005, the United States (US) was unprepared to assist patients facing disaster. We evaluate responses to Hurricane Katrina which caused unprecedented damage to health and property in the Gulf Coast1. As a result of the multitude of identified problems with the national, local, and kidney-specific responses to Katrina, new systems were created that mitigated loss following Hurricane Sandy in 2012. The improved disaster response system was no match for the COVID-19 pandemic; real-time changes worsened the impact on highly vulnerable populations including patients with ESKD. Similarly, preparation can only mitigate the difficulties faced by patients with ESKD living in a war zone. Government agencies need to provide tools and dialysis centers need to educate patients. Beginning with steps implemented in the aftermath of Hurricane Katrina and augmented following Hurricane Sandy, every patient with ESKD and those who care for them must begin emergency preparations before the need arises. Recognizing that it is not possible to prepare for every possible emergency, our healthcare systems must be ready to adapt to our everchanging world. After reviewing the responses to prior events, we suggest steps that should be considered to improve preparations for our uncertain future.

Clin J Am Soc Nephrol ; 2023 Feb 01.
Article in English | MEDLINE | ID: covidwho-2231968
Clin J Am Soc Nephrol ; 2023 Feb 01.
Article in English | MEDLINE | ID: covidwho-2224679
Front Med (Lausanne) ; 7: 604182, 2020.
Article in English | MEDLINE | ID: covidwho-1016066


The unprecedented surge of nephrology inpatients needing kidney replacement therapy placed hospital systems under extreme stress during the COVID-19 pandemic. In this article, we describe the formation of a cross campus "New-York Presbyterian COVID-19 Kidney Replacement Therapy Task Force" with intercampus physician, nursing, and supply chain representation. We describe several strategies including the development of novel dashboards to track supply/demand of resources, urgent start peritoneal dialysis, in-house preparation of kidney replacement fluid, the use of unconventional personnel resources to ensure the safe and continued provision of kidney replacement therapy in the face of the unanticipated surge. These approaches facilitated equitable sharing of resources across a complex healthcare-system and allowed for the rapid implementation of standardized protocols at each hospital.