When the earth trembles in the Americas: the experience of Haiti and Chile 2010.

The response of the nephrological community to the Haiti and Chile earthquakes which occurred in the first months of 2010 is described. In Haiti, renal support was organized by the Renal Disaster Relief Task Force (RDRTF) of the International Society of Nephrology (ISN) in close collaboration with Médecins Sans Frontières (MSF), and covered both patients with acute kidney injury (AKI) and patients with chronic kidney disease (CKD). The majority of AKI patients (19/27) suffered from crush syndrome and recovered their kidney function. The remaining 8 patients with AKI showed acute-to-chronic renal failure with very low recovery rates. The intervention of the RDRTF-ISN involved 25 volunteers of 9 nationalities, lasted exactly 2 months, and was characterized by major organizational difficulties and problems to create awareness among other rescue teams regarding the availability of dialysis possibilities. Part of the Haitian patients with AKI reached the Dominican Republic (DR) and received their therapy there. The nephrological community in the DR was able to cope with this extra patient load. In both Haiti and the DR, dialysis treatment was able to be prevented in at least 40 patients by screening and adequate fluid administration. Since laboratory facilities were destroyed in Port-au-Prince and were thus lacking during the first weeks of the intervention, the use from the very beginning on of a point-of-care device (i-STAT®) was very efficient for the detection of aberrant kidney function and electrolyte parameters. In Chile, nephrological problems were essentially related to difficulties delivering dialysis treatment to CKD patients, due to the damage to several units. This necessitated the reallocation of patients and the adaptation of their schedules. The problems could be handled by the local nephrologists. These observations illustrate that local and international preparedness might be life-saving if renal problems occur in earthquake circumstances.

When the earth trembles in the Americas: The experience of Haiti and Chile 2010

Ce document décrit les caractéristiques, les problèmes, les réussites et les leçons de l'intervention en Haïti suite au séisme de janvier 2010 du Renal Disaster Relief Task Force (RDRTF) de la Société Internationale de Néphrologie (ISN), ainsi que les conséquences néphrologiques du tremblement de terre chilien. Le RDRTF-ISN offre un soutien néphrologique en cas de grandes catastrophes, telles que les forts tremblements de terre pour lesquels un grand nombre de patients développent des lésions rénales aiguës (Acute Kidney Injury - AKI). Toutes les interventions sont intégrées dans les activités médicales de Médecins Sans Frontières (MSF - Médecins sans frontières). En Haïti la réponse a couvert tant les patients souffrant de lésions rénales aiguës que ceux atteints de maladies rénales chroniques. Au Chili les problèmes néphrologiques étaient essentiellement liés aux difficultés d'assurer la dialyse aux patients souffrant de conditions chroniques à cause de la destruction de plusieurs unités de dialyse.