Abstract
We investigated the death of patients undergoing chronic hemodialysis treatment who died after the Hanshin -Awaji earthquake. The number of hemodialysis patients in Hyogo prefecture who died in the one-year period following the disaster increased 26.0% over the preceding year. More specifically, the number of deaths increased markedly in January 1995, just after the disaster. There were no remarkable differences in the number of deaths between areas damaged by the disaster and those not damaged. An investigation into the cause of death revealed that cardiac diseases including heart failure and acute myocardial infarction accounted for the most of deaths, followed by infectious diseases such as pneumonia, and then cerebro-vascular diseases. The causes of death did not deviate markedly from those mentioned in statistical reports on hemodialysis patients in the country as a whole. The circumstances surrounding the death of 261 hemodialysis patients who died after the disaster were investigated. It was found that out of 79 patients affected by the earthquake, the homes of 52 had been destroyed, and many other patients changed hospitals because their hospitals had been damaged or because of transportation problems. Some changes in health or in laboratory findings were found in 21.8% of the patients and some psychiatric changes were evident in 23.0%. A total of 37.5% of patients were reported to be suffering from some degree of stress. It was estimated that stress to some degree affected the death of 25.2% of the patients. Proven effect of stress as well as changes in health, laboratory findings and mental state were found to a significantly higher degree in patients suffering from the earthquake.
