Abstract: PUB243
Climate Resilience for Nephrologists: The Role of Disaster Insurance
Session Information
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Reisinger, Nathaniel, Saint Louis Kidney Consultants, Saint Louis, Missouri, United States
- Reisinger, Helen Wiley, Insurance For Good, Philadelphia, Pennsylvania, United States
Background
Impacts of climate change are driving rising rates of AKI, CKD, and nephrolithiasis through increased heat stress, air pollution, and extreme weather. The 850 million people worldwide living with kidney disease are disproportionately vulnerable to climate impacts and healthcare infrastructure breakdown during disasters. Over 500,000 Americans requiring dialysis face life-threatening risk when water or power is disrupted by extreme weather events. Yet disaster insurance, a key lever for building financial resilience and enabling climate adaptation, remains largely outside the nephrology conversation.
Methods
Equitable insurance access is a social determinants issue. Households with disaster insurance recover more quickly and fully than those relying only on savings, aid, or credit. Lower-income and minority patients bear the highest burden of kidney disease and climate impacts, and are the least likely to be insured or able to access recovery assistance after a disaster.
Results
Nephrologists can help build climate resilience for kidney patients through disaster insurance in three ways. First, advocate for financial preparedness education for dialysis patients and other high-risk individuals. Coverage options vary by disaster type and may include homeowners or renters insurance, flood policies through the National Flood Insurance Program, or private market products. Second, mitigate patient risk by incorporating insurance status into social needs screening and connecting vulnerable patients to coverage resources before the next disaster strikes. Third, support policy innovation. Emerging instruments that pay out automatically based on objective triggers like flood gauge levels or wind speeds can deliver rapid liquidity to dialysis centers and health systems before traditional indemnity claims are processed, enabling faster restoration of life-sustaining care.
Conclusion
Nephrologists are well positioned to extend their advocacy beyond green dialysis and clinical preparedness to the broader insurance ecosystem. Helping patients achieve financial resilience before disaster strikes is an underutilized and high-impact opportunity to protect the most vulnerable from escalating climate threats.