Frequently Asked Questions — Dialysis Emergency Preparedness

Question 1

What should a dialysis patient pack in an emergency kit?

Accepted Answer

A dialysis emergency kit should include: 3 days of renal-friendly, shelf-stable food (low potassium, low phosphorus, low sodium); all prescription medications with a written list of names and doses; insurance cards and dialysis records; a first aid kit; a flashlight with extra batteries; bottled water; and copies of your emergency plan and backup dialysis center contacts. The Renal Preparedness Project offers a pre-assembled kit for $60 that includes renal-safe food and essential emergency supplies.

Question 2

What foods are safe for dialysis patients during an emergency?

Accepted Answer

Dialysis patients need shelf-stable foods that are low in potassium, phosphorus, and sodium. Safe options include: canned chicken or tuna (rinsed to reduce sodium), white rice, white bread or crackers, pasta, applesauce, canned pears or peaches (in juice, not syrup), and hard candy for quick calories. Avoid canned beans, tomatoes, potatoes, bananas, oranges, dairy products, and whole grains — these are high in potassium or phosphorus. Our emergency kits are pre-packed with renal-safe food options.

Question 3

How much water should dialysis patients store for emergencies?

Accepted Answer

Dialysis patients are typically on fluid restrictions, so water storage needs differ from the general recommendation of one gallon per person per day. Follow your nephrologist's prescribed fluid limit — usually 32–48 oz per day. Store enough bottled water to meet your daily fluid allowance for at least 3 days. Also store water for medication-taking and basic hygiene. Do not use tap water during a disaster until local authorities confirm it is safe.

Question 4

How should dialysis patients store medications during a power outage?

Accepted Answer

Keep medications in their original containers with labels intact. For medications that require refrigeration (such as certain blood pressure medications or insulin), keep them as cool as possible — a cooler with ice can maintain safe temperatures for 24–48 hours. Ask your pharmacist in advance which of your medications are temperature-sensitive and what the safe temperature range is. If power will be out for more than 48 hours, contact your dialysis center or nephrologist for guidance.

Question 5

What happens if a dialysis patient misses a treatment?

Accepted Answer

Missing even one dialysis session causes dangerous fluid and electrolyte buildup in the body. After one missed session, patients may experience swelling, shortness of breath, and rising potassium levels. After two missed sessions, potassium levels can reach life-threatening levels, causing irregular heartbeat (arrhythmia) — seek emergency care immediately. Three or more missed sessions is a medical emergency — call 911 or go to the nearest emergency room right away. Never delay seeking emergency dialysis during a disaster.

Question 6

What are the warning signs that a dialysis patient needs emergency care?

Accepted Answer

Call 911 immediately if you experience: chest pain or pressure; severe shortness of breath or difficulty breathing; irregular or rapid heartbeat; muscle weakness or paralysis; confusion or difficulty speaking; swelling so severe you cannot breathe comfortably; or if you have missed 3 or more dialysis sessions. These can be signs of hyperkalemia (dangerously high potassium), fluid overload, or other life-threatening complications from missed dialysis.

Question 7

What should dialysis patients do if their dialysis center is closed during a disaster?

Accepted Answer

Contact your ESRD (End-Stage Renal Disease) Network immediately — they maintain lists of open dialysis centers during disasters. Call your dialysis center's emergency line; most centers have protocols to redirect patients to alternate locations. You can also call the DaVita or Fresenius emergency hotlines even if you are not their patient. If you cannot reach any center and have missed two or more sessions, go to the nearest hospital emergency room and explain that you are a dialysis patient who has missed treatment.

Question 8

How long can a dialysis patient safely go without treatment?

Accepted Answer

This varies by individual, but as a general guideline: missing one session causes significant fluid and toxin buildup. Missing two sessions puts you at serious risk of hyperkalemia and cardiac complications. Missing three or more sessions is immediately life-threatening. Peritoneal dialysis patients may have slightly more flexibility, but should still seek care urgently if they cannot perform exchanges. Do not try to "wait out" a disaster — contact your care team or go to an emergency room if you cannot receive dialysis on schedule.

Question 9

How should dialysis patients prepare for a hurricane?

Accepted Answer

Start preparing 72 hours before a storm: Call your dialysis center to confirm their status and arrange treatment at an alternate location. Evacuate early — do not wait for a mandatory evacuation order. Pack your full emergency kit, all medications, insurance cards, and dialysis records. Know your evacuation route and have a destination with dialysis access. After the storm, avoid floodwater (it may be contaminated) and do not use tap water until authorities confirm it is safe. Register with your local emergency management office as a medically dependent resident before hurricane season.

Question 10

What should dialysis patients do during a power outage?

Accepted Answer

Contact your dialysis center immediately — many have backup generators and can continue treatments. If your home dialysis equipment requires power, contact your equipment supplier about battery backup options. Keep medications as cool as possible. Do not use a gas generator indoors — carbon monoxide is deadly. If you are on home dialysis and lose power for more than a few hours, call your care team. Dialysis patients may qualify for priority power restoration — contact your utility company in advance to register as a medically dependent customer.

Question 11

How should dialysis patients prepare for a wildfire evacuation?

Accepted Answer

Wildfire evacuations can happen with very little warning. Keep your emergency kit packed and ready to grab in under 5 minutes. Have your evacuation route planned in advance and know at least two alternate dialysis centers along that route. Sign up for local emergency alerts on your phone. If air quality is poor (AQI above 150), stay indoors with windows closed — dialysis patients with compromised immune systems are especially vulnerable to smoke inhalation. If you must evacuate, wear an N95 mask if available.

Question 12

What do dialysis patients need to know about extreme heat emergencies?

Accepted Answer

Dialysis patients are at high risk during extreme heat because their kidneys cannot regulate fluid and electrolytes normally. Stay in air-conditioned spaces as much as possible. Avoid outdoor activity during peak heat hours (10am–4pm). Be cautious about increased fluid intake — even in heat, you must stay within your prescribed fluid limits. Watch for signs of heat exhaustion: heavy sweating, weakness, cold/pale/clammy skin, weak pulse, nausea. If you experience these, move to a cool place and contact your care team. Heat stroke (hot/red/dry skin, rapid pulse, confusion) is a 911 emergency.

Question 13

How do dialysis patients register as medically dependent with emergency services?

Accepted Answer

Contact your county or city emergency management office and ask to be added to their Special Needs Registry or Vulnerable Persons Registry. Many utilities also have Medical Baseline or Life Support programs that prioritize power restoration for medically dependent customers — contact your electric company to enroll. Provide documentation from your nephrologist confirming your dialysis dependency. This registration helps emergency responders prioritize your needs during a disaster and can speed up power restoration to your home.

Question 14

What documents should dialysis patients keep in their emergency kit?

Accepted Answer

Keep copies of: your dialysis prescription and schedule; a complete medication list with names, doses, and prescribing doctors; insurance cards (Medicare, Medicaid, or private); your nephrologist's contact information; your dialysis center's address and emergency phone number; at least two backup dialysis center addresses and phone numbers; your ESRD Network contact; a list of your allergies; and your emergency contact information. Store these in a waterproof bag or folder inside your emergency kit.

Question 15

What is an ESRD Network and how can it help during a disaster?

Accepted Answer

ESRD Networks are federally-funded organizations that support dialysis patients across the United States. There are 18 ESRD Networks covering different regions of the country. During disasters, ESRD Networks coordinate with dialysis facilities to help displaced patients find open treatment centers. They maintain up-to-date information on which facilities are operational during emergencies. You can find your regional ESRD Network through the Centers for Medicare & Medicaid Services (CMS) website, or ask your dialysis center for your network's contact information.

Question 16

What nonprofit helps dialysis patients during emergencies?

Accepted Answer

The Renal Preparedness Project, Inc. is a 501(c)(3) nonprofit dedicated exclusively to emergency preparedness for dialysis and kidney disease patients. We provide pre-assembled dialysis emergency kits ($60 each), a free step-by-step Emergency Preparedness Guide, downloadable forms and checklists, and educational resources for patients and caregivers. Our mission is to ensure that no dialysis patient faces a disaster without a plan. Visit therenalpreparednessproject.org or call 470-327-2624 for more information.

Dialysis Emergency Preparedness FAQ

Emergency Kits & Supplies

Missed Dialysis & Medical Emergencies

Disaster-Specific Preparedness

Planning & Registration

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