Journal of Clinical & Experimental Nephrology

Patients who cannot Receive Hemodialysis in Neighborhood Dialysis Facilities: Report from the Area Near the Fukushima Nuclear Power Plants

Background: The Sousou area (Sousou) of Fukushima Prefecture, in which the Fukushima nuclear power plant is located, has a general population of 100,000, and approximately 200 hemodialysis (HD) patients. A substantial number of these patients are unable to receive HD at their local HD centers due to the serious shortage of medical staff worsened by the Great East Japan Earthquake and tsunami, and nuclear power plant accident. To receive HD, they must go to the Midorinosato Clinic (MC), a HD center in Miyagi Prefecture, located approximately 30-50 km north of Sousou. The number of such patients is now constantly increasing.

Methods and findings: We collected detailed information on 30 consecutive HD patients living in Sousou who were referred to the MC between December 22, 2014 and October 31, 2016. Of them, 10 patients who received HD 53.7 ± 18.5 times on an outpatient basis at the MC were accepted by HD centers in Sousou when spaces became available (Group A). However, no fewer than 12 patients were still receiving HD at the MC as of the end of October 2016 (Group B). In three patients, chronic kidney disease (CKD) was conservatively managed with a view to introduce HD at the MC (Group C). Five patients followed different clinical courses (Group D). Group D included patients who were referred to but could not go to the MC to receive HD for medical reasons such as severe cardiac failure and visual impairment.

Conclusions: A solution to the ongoing situation in Sousou where patients cannot receive HD at local facilities has yet to be found.

Author(s):

Takaaki Koshiba, Aki Ishida, Masayuki Hayashi and You Shishido

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