• Photo by Ed Kashi. Laborers prepare the Marakkanam salt pan fields for salt harvest near Pondicherry, India, on January 21, 2016.

Navigating Nephrology Care During Crises

Paul Hanna Paul Hanna, MD, MSc, is the director of onconephrology in the Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee. Rasha Raslan, MD, is with the Division of Nephrology, Department of Medicine, Duke University Hospital, Durham, NC.

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Photo by Ed Kashi. Laborers prepare the Marakkanam salt pan fields for salt harvest near Pondicherry, India, on January 21, 2016.

Citation: Kidney News 16, 4

This special section of Kidney News focuses on nephrology care in the face of global crises. Kidney News thanks Editorial Fellows Paul Hanna, MD, MSc, and Rasha Raslan, MD, for thoughtfully selecting and co-editing these articles.

In the world of nephrology, in which the delicate balance of health and disease defines the lives of millions worldwide, the impact of crises—whether natural disasters, wars, or the ongoing challenges of climate change—can be profound and far-reaching. In this special issue of Kidney News, we take a deep dive into the multifaceted challenges faced by patients, health care professionals, and nephrology communities when navigating nephrological care in times of emergencies. From the devastation brought on by hurricanes and tornadoes to the enduring hardships of warfare, the articles presented here offer a comprehensive exploration of the intersection between nephrology and crisis management. Through insightful commentary, expert analyses, and firsthand accounts, we shed light on myriad complexities that are inherent in providing and receiving nephrology care amid adversity.

We begin by delving into the challenges posed by climate change, exploring how extreme weather events and environmental factors exacerbate the vulnerabilities of patients dependent on dialysis and managing transplantation. From heatwaves and wildfires to disruptions in dialysis services caused by natural disasters, the articles underscore the pressing need for proactive measures and preparedness within the nephrology community to ensure the continuity of care in the face of climate-related crises. Next, we examine the impact of war on patients undergoing hemodialysis, highlighting the dire consequences faced by those disconnected from life-sustaining treatments in war-torn regions. As health care infrastructure crumbles and resources become scarce, patients are left vulnerable, underscoring the urgent need for international collaboration and humanitarian aid to mitigate the devastating effects of conflict on kidney health.

Lastly, in a deeply personal reflection, we hear from a young Syrian refugee living with lupus nephritis, whose journey from war-torn Syria to resettlement in the United States offers a poignant reminder of the resilience and determination of patients navigating nephrology care amidst adversity. Through their lived experiences, we gain valuable insights into the unique challenges faced by individuals and families grappling with chronic kidney disease in the midst of crises.

In addition to insightful content, this special section features powerful images by Ed Kashi, renowned photojournalist, filmmaker, speaker, educator, and recipient of the 2023 ASN President's Medal. His photography and films have documented how climate change and chronic kidney disease have become a global health crisis. The photos featured in this issue capture the experiences of individuals living with chronic kidney disease in regions with extreme heat, including India and Nicaragua.

I hope that by the end of this special section, you realize the importance of perseverance, patient-centered care, and patient advocacy. As we confront the aforementioned trials, we must remain committed to supporting our patients and communities, ensuring access to life-saving treatments, and advocating for policies that prioritize kidney health in times of exigencies. Together, we can successfully navigate the complexities of nephrology care in crises, drawing strength from the resilience of patients, the expertise of health care practitioners, and the collective resolve of the nephrology community to address the challenges ahead.


The author and section co-editors report no conflicts of interest.