Kidney Care in Times of Crises: A Review

Am J Kidney Dis. 2024 Nov;84(5):621-631. doi: 10.1053/j.ajkd.2024.03.030. Epub 2024 Jun 6.

Abstract

The global burden of kidney disease is increasing, paralleled by a rising number of natural and man-made crises. During these tumultuous times, accessing vital health care resources becomes challenging, posing significant risks to individuals, particularly those with kidney disease. This review delves into the impact of crises on kidney disease, with a particular focus on acute kidney injury (AKI), kidney failure, and kidney transplant. Patients experiencing crush injuries leading to AKI may encounter delayed diagnosis due to the chaotic nature of disasters and limited availability of resources. In chronic crises such as conflicts, patients with kidney failure are particularly affected, and deviations from dialysis standards are unfortunately common, impacting morbidity and mortality rates. Additionally, crises also disrupt access to kidney transplants, potentially compromising transplant outcomes. This review underscores the critical importance of preparedness measures and proactive management for kidney disease in crisis settings. Collaborative efforts among government bodies, rescue teams, health care providers, humanitarian agencies, and nongovernmental organizations are imperative to ensure equitable and reasonable care for kidney disease patients during times of crises, with the aim of saving lives and improving outcomes.

Keywords: Acute kidney injury; conflict; crisis; dialysis; disaster; kidney failure; rhabdomyolysis; transplantation.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / therapy
  • Disasters
  • Humans
  • Kidney Transplantation*
  • Renal Dialysis / methods
  • Renal Insufficiency / therapy