Indirect Disaster-Related Deaths Among Hemodialysis Patients Following the Fukushima Daiichi Nuclear Power Plant...

Disaster-related deaths (DRDs) are indirect fatalities caused by physical or psychological stress during evacuation. Patients undergoing hemodialysis (HD) face increased vulnerability during disasters due to reduced dialysis frequency, elevated mental stress, and limited access to medical resources. Although their risk is heightened, detailed analyses of DRDs in HD patients remain sparse.

This retrospective study analyzed 13 HD-related DRD cases in Minamisoma City, Fukushima Prefecture, following the Fukushima Daiichi Nuclear Power Plant accident. A total of 520 DRDs were certified in the city. Data from local government records were extracted, focusing on time of death, causes of death, and psychiatric symptoms.

The mean age (± standard deviation) at death for HD patients was 77.92 (±8.37) years, which was younger than the mean age (± standard deviation) of 82.81 (±11.97) years among non-HD individuals (Welch's t-test, p = 0.060). Most deaths occurred during the chronic phase of the disaster. Primary causes included exacerbation of chronic kidney disease, cardiovascular complications, and sepsis. Over half of the patients exhibited psychiatric symptoms such as depression or mood instability.

This case series illustrates the severe impact of disruptions in medical care and the stress of repeated evacuations. Challenges include insufficient continuity of care and prolonged psychological distress, particularly during the chronic disaster phase. Our findings suggest that ensuring uninterrupted HD and providing long-term psychological support may be essential to mitigating DRDs in this population.