Nephrology and Hypertension Associates, Bluefield, WV; The Syrian National Kidney Foundation, Bloomfield Hills, MI; Address reprint requests to Mohamed Sekkarie, MD, MPH, Nephrology and Hypertension Associates, PLLC, 188 Brookwood Dr, Charlottesville, VA 22902..
Metropolitan Access Center, Washington, DC.
Semin Nephrol. 2020 Jul;40(4):354-362. doi: 10.1016/j.semnephrol.2020.06.003.
Violent and protracted conflicts are disastrous to civilian populations and their health care systems. The complex requirements of caring for end-stage kidney disease (ESKD) dialysis patients in such contexts pose unique challenges. Dialysis is procedurally complex and resource-intensive. Delivering ESKD care in man-made conflict settings presents added challenges beyond what is required in natural disasters and resource-limited situations. In this article, we review the medical literature on, and document experience with, managing dialysis ESKD patients in conflict zones. We discuss the impact of war on patient outcomes, dialysis system infrastructure, operational funding, and risks to providers and organizations. This article provides recommendations to health care providers, educators, and policymakers on how to mitigate associated challenges.
暴力和持久的冲突对平民及其医疗保健系统造成了灾难性的影响。在这种情况下，照顾终末期肾病（ESKD）透析患者的复杂需求带来了独特的挑战。透析程序复杂，资源密集。在人为冲突环境中提供 ESKD 护理除了在自然灾害和资源有限的情况下所需的挑战之外，还带来了额外的挑战。在本文中，我们回顾了有关在冲突地区管理透析 ESKD 患者的医学文献，并记录了相关经验。我们讨论了战争对患者结局、透析系统基础设施、运营资金以及对提供者和组织的风险的影响。本文就如何减轻相关挑战向医疗保健提供者、教育工作者和政策制定者提供了建议。
