Abstract: SA-PO0405
Climate Shocks to Dialysis Fluid Supply Necessitate a Paradigm Shift in Production: Point-of-Care Fluid Generation as a Sustainable Solution
Session Information
- Home Dialysis: Science and Cases, from Lab to Living Room
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Karopadi, Akash, Management Consulting Division, Alira Health Boston LLC, Framingham, Massachusetts, United States
- Targa, Davide, Management Consulting Division, Alira Health, Barcelona, Spain
- Arya, Priyanka, Vivance Pte Ltd, Singapore, Singapore
- Venkataraya, Suresha Belur, Vivance Pte Ltd, Singapore, Singapore
- Gori, Mandar, Vivance Inc, Los Angeles, California, United States
Background
In 2024, Hurricane Helene flooded Baxter’s North Cove plant in North Carolina, halting operations and cutting ~60% of U.S. PD fluid supply, causing nationwide shortages. In 2025, wildfires forced dialysis clinic evacuations, disrupting patient care. These climate events underscore the urgent need for decentralized solutions across dialysis supply chain and care delivery. Point-of-care (POC) dialysis fluid generation offers a resilient alternative, reducing dependence on centralized manufacturing and vulnerable supply chains, ensuring care continuity during climate disruptions.
Methods
We reviewed reports from FDA, CDC, CMS, ASN, and ISPD detailing health advisories, emergency protocols and conservation strategies for PD fluid use following Hurricane Helene. These reports were analyzed to assess the reported clinical outcomes and provider testimonies.
Additionally, qualitative interviews with 12 stakeholders from large and medium dialysis organizations (LDO/MDOs) and independent clinics assessed the crisis impact and perceived value of a POC PD fluid generation system which reduces fluid logistics and storage need by 89%, by producing dialysate on-demand using tap water.
Results
Shortages led to bag-sparing regimens, delayed PD initiations, and in some cases, transition to in-center dialysis. Among interviewed stakeholders, 66.7% strongly agreed with adoption of POC fluid generation as a solution to supply chain limitations and clinical disruptions (Figure 1).
Conclusion
Climate events expose the vulnerability of a concentrated PD fluid supply chain, triggering shortages that threaten home dialysis expansion and investment. Decentralized innovations, like Vivance’s POC fluid generation system, offer a promising approach to enhance sustainability and scalability of home dialysis, strengthening resilience and supporting the continued expansion of home dialysis.
Figure 1. Expert Insights on PD Fluid Shortage Crisis and Vivance’s POC Dialysis Fluid Generation System