( Health services during natural disaster...)Nephrologists Reassess Disaster Response Strategies,Health

Health services during natural disasters have been in the spotlight especially after recent calamities like the hurricane Katrina . According to kidney specialists, well planned crisis management strategies are need of the hour, so that patients with end-stage renal failure undergoing regular dialysis are not in dire straits due to interruptions caused in the aftermath of natural disasters.

The July Clinical Journal of the American Society of Nephrology presents an update on the nephrology community's efforts to meet the unique needs of people with kidney disease in the aftermath of disaster. Drawing on the experience of nephrologists who responded to Hurricane Katrina, recent earthquakes in Asia, and other disasters, four articles in the special section draw on past lessons to inform future plans for responding to future crises. The articles are preceded by an introduction from Dr. Paul Kimmel, highlighting the role of the ASN and other professional organizations in planning the response to disasters.

Dr. Jeffrey Kopp of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, and coauthors analyze the lessons of two historic 2005 disasters: Hurricane Katrina and other storms that wreaked havoc along the U.S. Gulf Coast and the devastating earthquake in Kashmir, South Asia. After Katrina, 94 dialysis facilities in the region were closed for a week or longer including more than one-third of all centers in the state of Louisiana. The best guess is that of over 5,800 Gulf Coast dialysis patients affected by Katrina, 2.5 percent died in the month after the storm although given the high mortality rate among dialysis patients, it is difficult to determine how many deaths were storm-related.

The Kashmir earthquake offered different lessons, especially in terms of the risk of acute renal failure (ARF). This is a special concern in earthquakes or other causes of building collapse, because
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