Role of the International and National Renal Organizations in Natural Disasters: Strategies for Renal Rescue

Abstract

Besides loss of life and property, natural disasters result in a number of renal challenges, either by the creation of rhabdomyolysis and crush-induced acute kidney injury or by the destruction of existing dialysis facilities, leaving chronic dialysis patients and kidney transplanted patients without access to their regular dialysis, medications, or medical care. This review describes the organization and the many international interventions of the International Society of Nephrology Renal Disaster Relief Task Force over the past 2 decades. The close cooperation of the Task Force with an experienced nongovernmental organization, Médecins sans Frontières, allowed specific focus on renal problems by removing a number of organizational and logistical concerns related to disaster relief, which frequently have hampered operations in the past. After major earthquakes, adequate and early fluid resuscitation and supervising and applying acute hemodialysis in crush-induced acute kidney injury were the cornerstones of the interventions. In other disasters such as tornadoes or major floods, logistic and medical difficulties in disaster conditions and the need for implementation of a renal disaster relief preparedness program are underlined. The future role of a restructured task force in providing emergency disaster relief and the required logistical support is outlined.

Keywords: Renal disaster; acute kidney injury; crush syndrome; renal disaster preparedness.