Nephrological care in the conditions of martial law in Ukraine

Abstract

During armed conflicts (AC) and other disasters, the elderly, women, children, the infirm and the chronically ill patients are the most vulnerable population, with a high risk to health and life. Chronically ill people with kidney diseases, including those with kidney failure, deserve special attention due to their complete dependence on available functional infrastructure, and access to vital drugs and well-trained personnel. Currently, there is little information on the effects of AC on patients with kidney damage compared to the available data about the effects of other disasters. Mechanisms of injuries in AC and natural or man-made disasters have similar and distinctive features. Distinctive features: during AC — mainly gunshot and mine blast injuries, bleedings, poisonings by toxic substances, during disasters — hypothermia or burns, mechanical injuries, etc. Similar features include damage to infrastructure, particularly health care facilities, shortage of medicines, medical personnel, humanitarian and other crises, and a large number of injured and traumatized people in the hospitals. In this article, we systematized the material obtained during the military conflict, as well as reviewed domestic and foreign articles on this topic in order to optimize the work of nephrologists in the conditions of martial law and limited resources.

Keywords

• martial law
• chronic kidney disease
• refugees
• nuclear conflict
• renal replacement therapy
• dialysis
• kidney transplantation
• humanitarian crisis