Nephrologic Impact of Hurricanes Katrina and Rita in Areas Not Directly Affected.

Hurricanes Katrina and Rita resulted in enormous loss of life and disrupted the delivery of health care in areas affected by them. In causing mass movements of patients, natural disasters can overwhelm the resources of nephrology communities in areas not suffering direct damage. The following largely personal account evaluates the impact these hurricanes had upon the nephrology community, patients and health care providers alike, in areas not directly affected by the storms. Mass evacuation of hundreds of dialysis patients to surrounding areas overwhelmed the capacity of local hemodialysis centers. Non-availability of medical records in patients arriving without a supply of their routine medications led to confusion and sub-optimal treatment of conditions such as hypertension and congestive heart failure. Availability of cadaveric organs for transplantation was reduced in the surrounding areas, as the usual lines of communication and transportation were severed for several weeks. All of these issues led to prolong waiting times for patients on the transplant list. The hurricanes severely disrupted usual supply lines of medications to hospitals; certain rare conditions may be seen in higher numbers as a result of the shortages induced. We present the interesting surge in cases of acute kidney injury secondary to use of intravenous immune globulin.