By Jaymie Baxley
When Angela Gaskell began seeing images on social media showing Hurricane Helene’s catastrophic toll on western North Carolina, she asked herself: What becomes of the people on dialysis?
It was a natural question for Gaskell, a Moore County resident who spent five years on dialysis, first at clinics and then at home through peritoneal treatment, before receiving a kidney transplant in 2019.
“Looking at those posts brought back memories that I had forgotten and training that I had forgotten, and I started worrying, like, ‘Oh my gosh, what would I do?’” Gaskell said. “Missing just one day of dialysis is devastating for some people. If they’ve missed two in a row, it could put them in the danger zone.”
John Manley, a nephrologist at Mountain Kidney & Hypertension Associates in storm-ravaged Asheville, described it more bleakly. A single missed session, he said, “could potentially lead to death” for residents with kidney failure.
“The kidneys do a lot of things, but the main function is to remove toxins and fluid from the body,” he said. “Whenever you miss dialysis or you’re getting less-than-adequate dialysis, then you have an increased likelihood of developing too much fluid, or having too much fluid in your body, which can result in heart failure.”
Manley said the storm “changed everything” in his community. Widespread flooding, power outages and supply shortages made it difficult — if not impossible — for some patients to access treatment in Helene’s aftermath.
“In order to do dialysis, you have to have electricity, you have to have water and you have to have a building that hasn’t been flooded after a hurricane,” Manley said.
Clinic response
DaVita Kidney Care, one of the largest dialysis providers in western North Carolina, has taken steps to reduce the risk of patients missing treatment, deploying backup generators and tankers filled with water to its clinics in the region.
While the company temporarily closed a handful of treatment centers in some of the counties hit hardest by Helene, a spokesperson confirmed that only one of those facilities remained closed as of Thursday.
Hendersonville Dialysis Center, a DaVita-owned clinic in Henderson County, experienced significant flooding and may not reopen for several weeks. The clinic had 69 patients receiving in-person treatment in December 2023, the most recent month for which data is available from the N.C. Department of Health and Human Services.
For the time being, DaVita plans to transport those displaced patients to a treatment site in Forest City, which is about 40 miles east of Hendersonville in Rutherford County.
Tammy Leahy, vice president of the division that oversees DaVita’s operations in western North Carolina, acknowledged that the crisis might have been much worse if not for the company’s “rapid emergency management response and the extraordinary efforts of our team.”
“Our hearts go out to all the people affected by this storm, and especially those who faced great personal adversity to take care of neighbors in need,” Leahy said in a statement. “Our dedicated teammates have gone above and beyond to continue delivering care to patients in the wake of Hurricane Helene. Their contributions to the health and safety of this community cannot be overstated, and we owe them a debt of gratitude for their service and sacrifice.”
Manley also praised DaVita’s response, calling it “nothing short of amazing.”
“I’m amazed at how well they’ve prepared for this disaster,” he said. “It’s a miracle in my eyes. They’ve been right on top of it, and they’ve done a great job.”
Home patients
Many dialysis patients in the 25-county region declared a disaster area by FEMA receive hemodialysis or peritoneal treatment at home, according to data from NCDHHS.
At-home patients who rely on electronic dialysis machines are taught to manually administer treatment in the event of a power outage. But it’s rare for western North Carolina to experience massive storms that cause prolonged outages, and many residents may have never before needed to self-administer their exchanges.
“Even though everybody is trained, sometimes people forget about how to do that,” Manley said. “We’ve had nurses available 24/7 to be able to answer questions on how to manage their home dialysis. The problem is a lot of the cell towers are down, and just being able to have a conversation by phone is not possible.”
Manley and other kidney specialists have been trying to reach home dialysis patients through different channels. On Tuesday, he appeared on a local radio station to explain the process for manual treatment.
Much of the area’s dialysate, a fluid used for home dialysis, comes from a plant in McDowell County. Flooding from Helene caused extensive damage to the facility, forcing its owner Baxter International to temporarily halt production.
“The safety of our employees, their families, and the communities in which we operate remains our utmost concern, and we are committed to helping ensure reliable supply of products to patients,” José E. Almeida, CEO of Baxter International, said in a news release. “Remediation efforts are already underway, and we will spare no resource — human or financial — to resume production and help ensure patients and providers have the products they need.”
Manley does not believe the pause in production will be especially disruptive. He said Baxter officials have assured providers that the company has “enough supplies to get our peritoneal dialysis patients by for the next several months.”
“We’re not super concerned about it,” he said. “But it’s one of those things where, if you don’t anticipate an issue, then you aren’t going to be prepared.”
Donors needed
Gaskell, the kidney transplant recipient who has watched the devastation unfold from central North Carolina, worries that Helene will cause people to miss out on their own badly needed procedures.
Nearly 4,000 people are on the waiting list for a kidney in North Carolina, according to data from the Organ Procurement and Transplantation Network. More than 1,500 of those residents have been on the list for two years or longer.
Since receiving her transplant, Gaskell has met with state and federal lawmakers to advocate for legislation that would improve access to donated organs. She said the current plight of dialysis patients in western North Carolina underscores the need for such legislation.
“There are people on dialysis that might be qualified to get a kidney and are waiting, but might not make it because of this hurricane,” Gaskell said. “That scares me. The thought that people are eligible for a kidney, and might not get it because they might perish from this.”
Affected by Helene or wanting to help people who were? NC Health News has compiled a list of resources.
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