Earthquakes and Nephrology: Survey Results

by Raymond Vanholder

This enquiry was undertaken in the aftermath of the l’Aquila earthquake, which took place in Italy on April 6th, 2009, when we realized that not all nephrologists both inside and outside of Italy were aware of rescue plans regarding earthquake victims and crush patients, although they are among the main stakeholders.

The almost 600 responders were mainly clinical and dialysis nephrologists (88%).

Half of them were active in non-academic hospitals and 10% in free standing dialysis units.

All age categories were represented.

As expected, the majority was European, although a substantial fraction originated from South America (15%) and Asia (19% if including Middle East).

The large majority (92%) of responders was in favor of advance disaster plans,

but 79% was not aware of such a plan in their country/region. The latter figure may mean three things: a) there are no disaster plans; b) there are plans but they involve no nephrological aspects; c) there are no plans but the nephrologists are not aware of their existence. In all these cases, the local nephrological societies and/or nephrologists should play an active role in stimulating local authorities to develop those plans if they don’t exist, to adapt them if no focus is laid on nephrological aspects, or to get insight in their contents if they exist but are not known.

In addition, 92% is in favor of guidelines: recommendations on how to deal with crush.

In this context, it is comforting to know that a commission appointed by the International Society of Nephrology (ISN) is now developing such recommendations and is well advanced in this endeavor.