Puerto Rican Patients, Saline Industry Still Recovering

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In mid-April 2018, Puerto Rico again experienced a total blackout, this time because of an electrical subcontractor’s mistake, not an act of nature like Hurricane Maria, which devastated the island in September 2017.

Many patients have to travel far—sometimes up to 12 hours—to find functional dialysis opportunities. In March 2018, Puerto Rico’s health secretary said the department was working to bring in mobile units for dialysis. Luis Emanuelli, regional vice president of Fresenius Kidney Care, said he is aware of plans for the mobile units but is unaware of the timeline for bringing them on line.

To assist in getting help to people affected by Hurricane Maria, the National Kidney Foundation (NKF) set up a special fund for those needing dialysis. ASN joined NKF as a sponsor in the effort to raise money. Other organizations, and dialysis manufacturers and providers, joined in the effort:

  • ■ Akebia Therapeutics, Inc.

  • ■ Alliant Health Solutions

  • ■ Amgen Foundation

  • ■ American Renal Associates

  • ■ American Medical Technologists

  • ■ American Society of Nephrology

  • ■ American Society of Pediatric Nephrology

  • ■ DaVita Healthcare Partners

  • ■ Dialysis Clinic, Inc.

  • ■ Fresenius Medical Care

  • ■ Keryx Biopharmaceuticals

  • ■ National Renal Administrators Association

  • ■ OPKO Renal

  • ■ Relypsa, Inc.

  • ■ U.S. Renal Care

The hurricane-induced problems are a two-way street of dependence. The United States is very low on saline bags for dialysis, many of which are manufactured in Puerto Rico. The Washington Post reported that supply issues were made worse by the impact of Hurricane Maria on the medical products manufacturing sector in Puerto Rico, which affected small volume IV bags.

A statement from the US Food and Drug Administration (FDA) noted an effort to preserve the current stock of resources provided by Puerto Rican manufacturers. The FDA urged companies to submit data to extend expiration dates on products that could be stored for longer periods without safety issues.