Chronic Conditions · Dialysis & Kidney Disease
The one treatment that cannot wait.
Most medical needs can stretch a day or two in an emergency. Dialysis cannot. That makes continuity the whole task: knowing where you will be treated if your center is closed, keeping home equipment powered, and having the records that let any center pick up your care.
Planning guidance, not medical advice. Your nephrologist and dialysis care team provide the clinical guidance for your treatment. This guide prepares the continuity around it.
Planning guidance, not medical advice. This page does not tell you how to manage kidney disease or dialysis. It does not provide a renal diet, tell you what to do if a treatment is missed, or offer any clinical instruction. Those belong with your nephrologist, dialysis care team, and renal dietitian. What this page does is help you build the continuity plan around your treatment so a disruption is less likely to interrupt it.
What this guide covers
When treatment cannot pause, planning is the whole job.
Dialysis is unlike almost any other medical need in an emergency, because it runs on a schedule that a disruption cannot be allowed to break for long. A closed center, a flooded road, or a multi-day power outage is not an inconvenience for someone on dialysis. It is a direct threat to a treatment that keeps them alive.
The reassuring part is that this exact problem has been studied, and the protective actions are known and ordinary. This guide covers three of them: keeping your center-based treatment continuous, keeping home dialysis powered and supplied, and handling the renal diet when normal food is not available.
What this guide does not cover
The renal diet itself, or any specific food limits, which come from your renal dietitian
What to do medically if a treatment is delayed or missed, which is a question for your care team
How to perform any part of your dialysis, including manual exchanges, which your training and team provide
Managing diabetes alongside kidney disease, covered in Diabetes Preparedness
What the evidence says about preparation
After Hurricane Katrina, researchers interviewed 386 dialysis patients from nine New Orleans units about what happened to their treatment.
Nearly half missed at least one dialysis session, and about one in six missed three or more. Missing three or more roughly doubled the odds of being hospitalized.1
The finding that matters most for planning is what set the two groups apart. Patients were more likely to miss treatments if they were unaware of their dialysis facility's emergency plan, if they lived alone, and if they did not act or evacuate early.1
Knowing your center's plan and acting early are not small details. In the one large study of this exact situation, they were what separated the patients who kept their treatment from those who did not.
Everything in this guide is a way of being the prepared patient that study describes: one who knows the plan, has a second option, and moves early.
Center-based continuity
Always know your second option.
If you dialyze at a center, the core of your plan is simple to state: never depend on a single building. Know where else you could be treated, know your own center's plan, and be reachable.
Three things to arrange in advance
Identify a second center. Find another dialysis center near you before you ever need it, and keep its contact information in your kit. Your care team, the KCER hotline, or a dialysis-center locator can help you find one.
Learn your center's emergency plan. Ask your center directly what happens in a disaster: whether they stay open, where they route patients, and how they will reach you. The Katrina research found that simply knowing this plan was protective.
Keep your center reachable. Make sure your center always has your current phone number and address, so they can contact you about schedule changes or relocations.
The kit and records you carry
Any center that treats you in an emergency needs to know your treatment quickly. Pack a kit with the details that make that possible:
Contact numbers for your doctor, your regular center, and a second center
Your medication list and a three-day supply of each medication
Your dialysis prescription, your dry weight, and your access type
A patient identification card and your emergency diet plan
Kidney patient identification cards are available from the national kidney organizations to hold exactly this information in one place.
Numbers to keep before you need them
Kidney Community Emergency Response (KCER)
1-866-901-3773. A program of the End Stage Renal Disease National Coordinating Center under contract with the Centers for Medicare and Medicaid Services, KCER helps patients and providers locate dialysis during a disaster.3
National Kidney Foundation Cares
1-855-653-2273. Patient support and emergency resources for people with kidney disease and their families.4
The renal diet in an emergency
When food is what you can control.
A renal diet already restricts fluid and several minerals, and an emergency makes that harder in two ways at once. Standard emergency food, built around canned and shelf-stable goods, tends to be high in exactly the things a renal diet limits. And if a treatment is delayed, what you eat and drink between treatments matters more than usual.
This is the one area where a specific plan from your care team is essential, not optional. There is a recognized emergency eating plan for dialysis patients, and it is a clinical tool, not something to assemble from general advice.
Ask your dietitian for the emergency diet
The 3-Day Emergency Diet is an eating plan designed to reduce the waste that builds up in your blood when you cannot keep your normal dialysis schedule.2,3 Because it is a clinical plan, ask your renal dietitian or care team for the version that fits you, keep a printed copy with your records, and do not improvise it. It is exactly the kind of document to have in hand before an emergency, not to look for during one.
Stock a supply that fits the renal diet
When you build a home food supply, choose shelf-stable options that fit renal restrictions rather than defaulting to standard high-sodium canned goods. Your dietitian can tell you which shelf-stable foods work within your limits. Planning this before an event means your emergency shelf and your diet do not work against each other.
Medical Diets in EmergenciesBuilding and rotating that supply is part of the wider work of a home food store, covered in the Food section.
Home dialysis
At home, you own the utilities too.
Home dialysis gives you independence from the center, and in exchange it puts the power and water your treatment needs on your own shoulders. Both are things to plan before an outage, not during one.
Power and supplies
A home dialysis machine runs on electricity, so a power outage interrupts treatment. Plan backup power in advance, whether that is a small generator or a power station sized for your equipment, and keep a supply buffer of what your treatment consumes.
Register with your electric company for priority service restoration, and keep your equipment supplier's emergency number where you can find it. If a treatment might be delayed, ask your care team in advance what they want you to do, so you are following their plan rather than guessing.
Sizing backup power to a medical device is its own task, covered in the guides below.
Water
Home hemodialysis depends on clean water, which means a water outage or a boil-water advisory can reach your treatment the same way a power outage does. This is easy to overlook, because most emergency planning treats water as a matter of drinking supply rather than medical supply.
Register with your water company as well as your power company for priority restoration, keep the supply buffer your setup requires, and follow your care team's guidance for an interrupted water supply. Understanding your household's water resilience in general helps here.
Whether you dialyze at home or at a center, telling your utilities that you depend on life-sustaining equipment is one of the highest-value calls you can make before a disaster. Ask your electric and water companies how to register your address for priority restoration. It costs a phone call now and can move you up the list when service is being brought back.
Common questions
Planning questions, answered plainly.
What if my dialysis center is closed or I cannot reach it?
Identify a second center near you before an emergency, know your own center's emergency plan and where it routes patients, and keep your contact information current with them. During a disaster, the KCER hotline at 1-866-901-3773 and NKF Cares at 1-855-653-2273 can help you locate dialysis. Research after Hurricane Katrina found that patients who knew their facility's plan and acted early were less likely to miss treatments.1
What is the 3-Day Emergency Diet?
It is an eating plan meant to reduce the waste that builds up in your blood if you are temporarily unable to keep your normal dialysis schedule.2,3 Because it is a clinical plan, the version that is right for you should come from your renal dietitian or care team. Ask them for it, keep a copy with your records, and do not improvise it from general information.
My home dialysis machine needs power. What should I plan?
Plan backup power before an outage, whether a small generator or a power station sized for your equipment, and keep a supply buffer. Register with both your electric and water companies for priority restoration, keep your supplier's emergency number handy, and ask your care team in advance what to do if a treatment is delayed.
What about water for home dialysis?
Home hemodialysis depends on clean water, so a water outage or boil-water advisory can affect it. Register with your water company for priority restoration, keep the supply buffer your setup requires, and follow your care team's guidance when the water supply is interrupted.
What should I keep in my emergency kit and records?
Contact numbers for your doctor, your regular center, and a second center; your medication list with a three-day supply; your dialysis prescription, dry weight, and access type; a patient identification card; and your emergency diet plan. Keep it all together with your household medical profile so it travels with you.
Sources
1 Anderson AH, Cohen AJ, Kutner NG, Kopp JB, Kimmel PL, Muntner P. "Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina." Kidney International 2009;75(11):1202-1208. doi:10.1038/ki.2009.5.
2 Centers for Disease Control and Prevention. "What to Do When You Need Dialysis During an Emergency" (cdc.gov). Accessed September 4, 2026.
3 Kidney Community Emergency Response (KCER) Coalition, a program of the ESRD National Coordinating Center under contract with the Centers for Medicare and Medicaid Services (kcercoalition.com). Accessed September 4, 2026.
4 National Kidney Foundation. "Emergency Resources for Kidney Patients" (kidney.org); NKF Cares 1-855-653-2273. Accessed September 4, 2026.
Who to contact
The conversations to have now
Your nephrologist and dialysis care team
For your emergency plan, your emergency diet, and what they want you to do if a treatment is delayed.
Your dialysis center
Keep your contact information current, and ask about their emergency plan and where they route patients.
KCER hotline
1-866-901-3773, to locate dialysis during a disaster.
NKF Cares
1-855-653-2273, for kidney patient support and emergency resources.
Your electric and water utilities
To register life-sustaining equipment for priority service restoration during an outage.
Related guides
Keep going.
These guides connect directly to dialysis and kidney planning. Read them alongside this one for the complete picture.
Medical Devices and Power
Backup power for a home dialysis machine or any powered medical device during an outage.
Household Water Resilience
Storing, treating, and securing water, which for home hemodialysis is a medical supply as much as a drinking supply.
Medical Diets in Emergencies
Planning renal, diabetic, and cardiac diets when standard emergency food does not meet medical needs.
Prescription Preparedness
The framework for a medication buffer and the three-day supply that belongs in your kit.
Diabetes Preparedness
Diabetes is a leading cause of kidney disease, and many people plan for both together.
Household Medical Profile
The one document that holds your prescription, access type, providers, and records in a grab-and-go form.
"Chance favors the prepared mind."
Louis Pasteur
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