Department of Medicine, Division of Nephrology, Mayo Clinic, Phoenix, Arizona.
Department of Medicine, Division of Nephrology, University of Minnesota, Minneapolis, Minnesota.
Am J Kidney Dis. 2024 Nov;84(5):621-631. doi: 10.1053/j.ajkd.2024.03.030. Epub 2024 Jun 6.
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.
全球范围内肾脏疾病的负担正在增加,同时也出现了越来越多的自然和人为危机。在这些动荡时期,获取重要的医疗保健资源变得具有挑战性,这对个人,特别是肾脏疾病患者,构成了重大风险。本文深入探讨了危机对肾脏疾病的影响,特别是急性肾损伤 (AKI)、肾衰竭和肾脏移植。因灾难的混乱性质和资源有限,经历挤压伤导致 AKI 的患者可能会出现延迟诊断。在慢性危机如冲突中,肾衰竭患者受到的影响尤其大,而且不幸的是,透析标准的偏离很常见,这影响了发病率和死亡率。此外,危机也会影响肾脏移植的获取,可能会影响移植的结果。本综述强调了在危机环境下为肾脏疾病做好准备措施和积极管理的重要性。政府机构、救援队伍、医疗保健提供者、人道主义机构和非政府组织之间的合作至关重要,以便在危机期间为肾脏疾病患者提供公平和合理的护理,以拯救生命和改善结果。