Background: Major earthquakes are followed by a substantial number of crush syndromes and pigment-induced acute renal failures (ARFs). The natural evolution of this problem rapidly leads to death. Today's possibilities of dialysis therapy enable saving numerous lives that otherwise would be lost. Currently, the primary problem is organizational, if huge catastrophes occur and complex therapeutic options need to be offered to a large number of victims.
Methods: Following the 1988 Spitak earthquake in Armenia, the International Society of Nephrology (ISN) established the Renal Disaster Relief Task Force (RDRTF) in order to anticipate organizational problems related to renal care in the aftermath of large natural and human-made catastrophes. The proposed concept was one of a dialysis advance team, which would assess the needs and possibilities of dialysis treatment, to be followed by supportive manpower and supplies. This article describes the organizational aspects of a rescue action that was undertaken following the Marmara earthquake, which occurred on August 17th, 1999, in northwestern Turkey. In conjunction with Médecins Sans Frontières, a team landed at Istanbul Airport less than 22 hours after the disaster, and logistic and material support as well as manpower were provided over a period of approximately one month. Specific attention was paid to the choice of the renal replacement therapy, the transport of victims and materials, the implementation of preventive rehydration, and the problem of chronic renal failure patients dialyzed in the damaged area.
Conclusions: We demonstrate how previously anticipated international support may offer moral, financial, as well as logistical help to local nephrological communities confronted with serious disasters.