Recommendations of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists regarding medical care to kidney disease patients during the war

Abstract

Abstract. The occurrence of an emergency situation (ES) forced international (ISN, EDTA/ERA) and national (Turkey) nephrological associations to establish the Renal Disaster Relief Task Force, which is primarily concerned with the treatment of patients with acute kidney injury and end-stage renal disease requiring dialysis. The war started by the RF is putting the Ukrainian state, Ukrainian society, and the healthcare system in the catastrophic ES. Under these circumstances, all nephrological patients became one of the most vulnerable categories of patients.
 To provide immediate support in solving problems within the Ukrainian Association of Nephrologists and Kidney Transplant Specialists (UAN&KTS), the Ukrainian Renal Disaster Relief Committee (URDRC) has been established. One of the most important tasks was to form a group of experts to develop recommendations for specialized medical care for kidney patients in wartime.
 According to the experts, the key person for this type of medical care is the leading nephrologist in the region or city. He/she establishes a local Renal Disaster Relief Committee (LRDRC) and decides through horizontal (with other LRDRC) or vertical (with UAN &KTS) collaboration, using available communication tools, on the problems that arise; the most appropriate tool is the Viber platform "Nephrology. Dialysis. Transplantation". In this way, a network without administrative subordination and a non-hierarchical functional system was created, which, on the one hand, functions according to similar working principles, but, on the other hand, may differ in terms of LRDRC composition, communication methods, and more.
 The LRDRC divides all patients into three groups and provides work preparation measures before, during and after the cancellation of ES.

One year of the full-scale war in Ukraine and kidney replacement therapy: Where do we stand now? A brief report of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists

“…The return of part of the patients from European countries Establishment of the Ukrainian Kidney Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists Issuance of the Recommendations for medical care of patients with kidney diseases during the war [2],…”

Peculiarities of Arteriovenous Prosthesis Functioning in Patients on Hemodialysis

“…According to recently published data from the US Department of Health and Human Services, among all hemodialysis patients in 2020 62.60% of patients used an arteriovenous fi stula, 20.70% used a temporary or permanent central venous catheter, and 16.70% of patients -used an arteriovenous prosthesis [2].Due to the peculiarities of hemodynamics and the hemodialysis procedure, the most common vascular access lesions are thrombosis, stenoses, aneurysms, pseudoaneurysms, and infectious lesions. As a result of processing the data of more than 77 thousand sick residents of the USA with the terminal stage of CKD, who are on HD, among patients with arteriovenous fi stula during the 3 years of its use, 69.11% required surgical intervention in order to restore the functioning of vascular access, on the other hand, the need for surgical correction of arteriovenous prostheses for the corresponding period was greater and amounted to 87.21% [3].In Ukraine, as of February 1, 2023, there were treated 11,181 people with the help of the RRT method, of which 8,717 were treated by the HD method, that is, they needed permanent vascular access [4]. In the world, and in our country in particular, there is a tendency to increase the prevalence of CKD, therefore, the search for effective methods of preventing the development of hemodynamic lesions of arteriovenous accesses and increasing the duration of their use for RRT remains relevant.Therefore, the aim of this study was a retrospective analysis of hemodynamic disorders and peculiarities of the use of arteriovenous prostheses as permanent vascular access in patients undergoing hemodialysis therapy.…”

“…In Ukraine, as of February 1, 2023, there were treated 11,181 people with the help of the RRT method, of which 8,717 were treated by the HD method, that is, they needed permanent vascular access [4]. In the world, and in our country in particular, there is a tendency to increase the prevalence of CKD, therefore, the search for effective methods of preventing the development of hemodynamic lesions of arteriovenous accesses and increasing the duration of their use for RRT remains relevant.…”