Document Type



Media is loading

Publication Date



Presentation: 5:32


Chronic kidney disease (CKD) – a progressive loss of renal function – is a growing health burden for which dialysis or kidney transplant is a requirement for survival in the last stage. Natural disasters can readily disrupt dialysis provision, translating into life-threatening events for people whose lives depend on dialysis. The adverse outcomes associated with missed dialysis sessions are likely exacerbated in island settings. At the end of 2018, there were 68 patients on dialysis in the Cayman Islands. The Cayman Islands, like many island settings, are susceptible to natural disasters, putting the dialysis community at risk. To inform policy interventions, we systematically reviewed studies examining the effects of natural disasters on dialysis patients, and discussed the implications for emergency preparedness in the Cayman Islands. Two reviewers independently screened 424 titles and abstracts from PubMed, Scopus, CINAHL, and Cochrane Library. We included studies if they were original research articles published in the English language, and conducted in the Americas from 2009 to 2019. Our search yielded 15 relevant papers, which we included in the final analysis. Results from this systematic review show that natural disasters have both direct and indirect effects on dialysis patients. Lack of electricity, potable water, transportation, and closure of dialysis facilities can disrupt dialysis care, leading to missed dialysis sessions, and increases in hospitalizations and emergency department use. Additionally, natural disasters can exacerbate depression and lead to the onset of post-traumatic stress disorder for dialysis-dependent patients. To our knowledge, this systematic review is the first study that presents a synthesis of the literature on the effects of natural disasters on dialysis populations. The findings of this review have several implications for emergency planning and may inform policy interventions for dialysis patients in the Cayman Islands.