Disasters, children and the kidneys

Abstract

Following disasters, children are physically, psychologically and socially more vulnerable than adults; consequently, their morbidity and mortality are higher. The risks are especially high for orphans and unaccompanied children who are separated from their families, making them frequently victims of human trafficking, slavery, drug addiction, crime or sexual exploitation. Education of children and families about disaster-related risks and providing special protection in disaster preparedness plans may mitigate these threats. Kidney disease patients, both paediatric and adult, are extra vulnerable during disasters, because their treatment is dependent on technology and functioning infrastructure. Acute kidney injury, chronic kidney disease patients not on dialysis and dialysis and transplant patients are faced with extensive problems. Overall, similar treatment principles apply both for adults and paediatric kidney patients, but management of children is more problematic, because of substantial medical and logistic difficulties. To minimize drawbacks, it is vital to be prepared for renal disasters. Preparedness plans should address not only medical professionals, but also patients and their families. If problems cannot be coped with locally, calling for national and/or international help is mandatory. This paper describes the spectrum of disaster-related problems in children and the specific features in treating acute and chronic kidney disease in disasters.

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Acknowledgements

M.S.S. is a member of and volunteer for Médecins Sans Frontières (MSF) and served as field doctor and disaster relief coordinator in many mass disasters.

L.S. treated many paediatric crush victims and contributed to paediatric relief operations after the Marmara earthquake.

R.V. coordinated and took part in several disaster relief operations in collaboration with MSF. Between 2005 and 2014, he coordinated the Renal Disaster Relief Task Force (RDRTF) of the ISN.

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Correspondence to Mehmet Sukru Sever.

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Sever, M.S., Sever, L. & Vanholder, R. Disasters, children and the kidneys. Pediatr Nephrol 35, 1381–1393 (2020). https://doi.org/10.1007/s00467-019-04310-x

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Keywords

  • Disasters
  • Children
  • Crush syndrome
  • Dialysis
  • Refugee children
  • Paediatric victim