Disasters and kidney care: pitfalls and solutions

Sever, Mehmet Şükrü; Luyckx, Valérie A.; Kazancıoğlu, Rümeyza; Rodgers, Darlene; Gallego, Daniel; Vanholder, Raymond

doi:10.1038/s41581-023-00743-8

Cited by 16 publications

(5 citation statements)

References 134 publications

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“…In the current study, there was a significant correlation between lactate level, which is a global perfusion indicator, and the development of AKI. AKI may also develop as a result of myoglobin, uric acid, and phosphorus, which occur as a result of tissue damage, causing tubular damage, as shown in this study [ 10 , 17 , 19 ].…”

Section: Discussionmentioning

confidence: 91%

Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit

Aydin,

Ozel Yesilyurt,

Cetinkaya

et al. 2024

BMC Emerg Med

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Background After the Kahramanmaras earthquake of February 6, 2023, the disaster of the century, a significant number of victims were admitted to intensive care units (ICUs). In this study, we aimed to share the characteristics and management of critical earthquake victims and shed light on our experiences as intensivists in future earthquakes. Methods The study included 62 earthquake victims in two tertiary ICUs. Demographic characteristics, laboratory findings, clinical characteristics, trauma and disease severity scores, treatments administered to patients, and the clinical course of the patients were recorded retrospectively. The patients were divided into two groups, survivors and nonsurvivors, according to 7-day mortality and into two groups according to the duration of their stay under the rubble: those who remained under the rubble for 72 hours or less and those who remained under the rubble for more than 72 hours. A receiver operating characteristic (ROC) curve analysis was used to determine the best cutoff value for the ‘Circulation, Respiration, Abdomen, Motor, and Speech’ (CRAMS) score. Results The median age of the 62 patients included in the study was 35.5 (23-53) years. The median length of stay under the rubble for the patients was 30.5 (12-64.5) hours. The patient was transferred to the ward with a maximum duration of 222 hours under the rubble. The limb (75.8%) was the most common location of trauma in patients admitted to the ICU. Crush syndrome developed in 96.8% of the patients. There was a positive correlation between the development of acute kidney injury (AKI) and myoglobin, serum lactate, and uric acid levels (r = 0.372, p = 0.003; r = 0.307, p = 0.016; r = 0.428, p = 0.001, respectively). The best cutoff of the CRAMS score to predict in-7-day mortality was < 4.5 with 0.94 area under the curve (AUC); application of this threshold resulted in 75% sensitivity and 96.3% specificity. Conclusion Search and rescue operations should continue for at least ten days after an earthquake. The CRAMS score can be used to assess trauma severity and predict mortality in critically ill earthquake victims.

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Section: Discussionmentioning

confidence: 91%

Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit

Aydin,

Ozel Yesilyurt,

Cetinkaya

et al. 2024

BMC Emerg Med

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“…War can damage or destroy hospitals, clinics, laboratories, pharmacies, ambulances, and other medical facilities, equipment, and supplies. War can also disrupt the delivery of essential medicines, vaccines, blood products, and other medical commodities [ 2 ].…”

Section: Editorialmentioning

confidence: 99%

“…The constant threat of violence, loss of loved ones, and the experience of displacement contribute to heightened stress, anxiety, and depression among this demographic. The psychosocial impact is not to be underestimated, as studies have demonstrated the significant role these factors play in the progression of chronic diseases, including kidney disease [ 2 ].…”

Section: Editorialmentioning

confidence: 99%

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The Silent Victims: How the Israel-Palestine War Impacts the Management of Chronic Kidney Disease and End-Stage Renal Disease Patients

Lohana,

Gulati,

Kumar

et al. 2024

Cureus

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This article discusses the multifaceted impact of wars and armed conflicts on healthcare systems, with a focus on the Israel-Palestine war and its consequences for individuals with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The war has severely disrupted healthcare infrastructure, leading to damage or destruction of hospitals and clinics, shortages in medical supplies and staff, and interruptions in the delivery of essential services. This disruption poses significant challenges for the management of chronic conditions such as CKD and ESRD, where patients rely on regular and specialized care. The article highlights the logistical challenges and health risks faced by these patients, including the interruption of dialysis treatment, shortages of medications, and the impact of displacement on continuity of care. It also addresses the psychological toll on patients, emphasizing the increased stress, anxiety, and depression that can exacerbate their condition. The need for international aid and humanitarian efforts to support CKD and ESRD patients in conflict zones is underscored, along with the importance of addressing the root causes of the conflict to ensure the well-being of vulnerable populations.

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“… 2 Their aftermath extends well beyond immediate physical damage, profoundly impacting health care systems and exacerbating vulnerabilities within affected communities. Nephrology, given the prevalence of acute kidney injury and chronic kidney disease, plays a pivotal role in disaster response efforts, leading to the emergence of the field known as “disaster nephrology.” 3 Amid such crises, peritoneal dialysis (PD) emerges as a vital lifeline, offering patients a versatile and efficient home-based kidney replacement therapy.…”

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confidence: 99%

Enhancing Disaster Preparedness in Peritoneal Dialysis Care

Sahutoglu,

Kazancioglu

2024

Kidney International Reports

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Disasters and kidney care: pitfalls and solutions

Cited by 16 publications

References 134 publications

Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit

Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit

The Silent Victims: How the Israel-Palestine War Impacts the Management of Chronic Kidney Disease and End-Stage Renal Disease Patients

Enhancing Disaster Preparedness in Peritoneal Dialysis Care

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