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Abstract
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Earthquakes, as capricious acts of nature, pose substantial threats to both human life and infrastructure.
The recent twin earthquakes that struck southern Turkey in 2023 serve as stark reminders of the devastating potential of such events.2
Their aftermath extends well beyond immediate physical damage, profoundly impacting health care systems and exacerbating vulnerabilities within affected communities. Nephrology, given the prevalence of acute kidney injury and chronic kidney disease, plays a pivotal role in disaster response efforts, leading to the emergence of the field known as "disaster nephrology."3
Amid such crises, peritoneal dialysis (PD) emerges as a vital lifeline, offering patients a versatile and efficient home-based kidney replacement therapy.
In light of this, the Turkey earthquakes highlighted the critical need for disaster preparedness, particularly among vulnerable populations such as patients undergoing PD whose specific challenges remain poorly understood. To address this gap, we conducted a retrospective multicenter investigation to delve into the postearthquake experiences of PD survivors following the Kahramanmaraş earthquake in 2023. Our study aimed to comprehensively assess various aspects of patients' lives and treatment before and after the earthquake, using an extensive anonymized online questionnaire distributed to patients undergoing PD and direct communication with health care providers in the affected region.
The study involved 101 patients undergoing PD from the earthquake-affected region of Kahramanmaraş, with data collected approximately 92 days after disaster. The median age of patients was 45 years, with a median PD duration of 24 months, and a majority were using continuous ambulatory PD (78%). During the earthquake, 3 patients were trapped but rescued within a median time of 10 hours, whereas postdisaster challenges included power outages, water shortages, and limited access to hygiene materials. Two patients experienced impaired access to PD supplies lasting 4 days, and transitions between automated PD and continuous ambulatory PD modalities were observed. Communication with PD care centers was maintained by 60% of patients, and 16% had undergone disaster preparedness training. Temporary hemodialysis was initiated for 3 patients, and 3 patients discontinued PD after the earthquake, with 1 case attributed to fungal peritonitis. Clinical parameters remained stable overall, although a mild decrease in median hemoglobin levels was observed. Seven patients experienced peritonitis after the earthquake, with successful resolution in most cases except for 1 instance, which required transfer to hemodialysis.
These findings underscore the critical importance of disaster preparedness in nephrology, particularly for patients undergoing PD. The study reveals the resilience of patients undergoing PD in maintaining clinical stability despite facing challenges such as power outages and water shortages. Moreover, it highlights the need for tailored disaster response protocols to address the unique needs of patients undergoing PD, including provisions for alternative treatment modalities and enhanced infection control measures.
The findings from our study, when correlated with existing data, emphasize...
Language: en |