When the Earth trembles in the americas: the experience of haiti and chile 2010.
Ferir, M C
Luyckx, V A
Sever, M S
AffiliationNephrology Section, Ghent University Hospital Belgium; Rouen University Hospital; Nephrology Department, Dialysis Unit, Bois Guillaume Hospital, France; Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Médecins Sans Frontières, Belgium; Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Canada; Nephrology Section, Arzobispo Loayza General Hospital, Cayetano Heredia Peruvian University, Peru; Division of Nephrology, Department of Medicine, University of Alberta, Canada; Division of Nephrology, University of Arkansas for Medical Sciences, Arkansas, USA; Nephrology Section, Hospital Regional Antonio Musa, Universidad Central del Este, Dominican Republic; Department of Internal Medicine and Nephrology, Istanbul School of Medicine, Turkey; Nephrology Section, Department of Internal Medicine, Service of Internal Medicine and Nephrology, Department of Internal Medicine, Hospital Militar de Santiago, University of the Andes and Valparaiso, Chile
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JournalNephron Clinical Practice
AbstractThe response of the nephrological community to the Haiti and Chile earthquakes which occurred in the first months of 2010 is described. In Haiti, renal support was organized by the Renal Disaster Relief Task Force (RDRTF) of the International Society of Nephrology (ISN) in close collaboration with Médecins Sans Frontières (MSF), and covered both patients with acute kidney injury (AKI) and patients with chronic kidney disease (CKD). The majority of AKI patients (19/27) suffered from crush syndrome and recovered their kidney function. The remaining 8 patients with AKI showed acute-to-chronic renal failure with very low recovery rates. The intervention of the RDRTF-ISN involved 25 volunteers of 9 nationalities, lasted exactly 2 months, and was characterized by major organizational difficulties and problems to create awareness among other rescue teams regarding the availability of dialysis possibilities. Part of the Haitian patients with AKI reached the Dominican Republic (DR) and received their therapy there. The nephrological community in the DR was able to cope with this extra patient load. In both Haiti and the DR, dialysis treatment was able to be prevented in at least 40 patients by screening and adequate fluid administration. Since laboratory facilities were destroyed in Port-au-Prince and were thus lacking during the first weeks of the intervention, the use from the very beginning on of a point-of-care device (i-STAT®) was very efficient for the detection of aberrant kidney function and electrolyte parameters. In Chile, nephrological problems were essentially related to difficulties delivering dialysis treatment to CKD patients, due to the damage to several units. This necessitated the reallocation of patients and the adaptation of their schedules. The problems could be handled by the local nephrologists. These observations illustrate that local and international preparedness might be life-saving if renal problems occur in earthquake circumstances.