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      Treatment Modalities and Outcome of the Renal Victims of the Marmara Earthquake

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          Abstract

          Background/Aims: Treatment of renal problems during natural catastrophes is highly complicated both for medical and logistic reasons. The therapeutic interventions applied to and the outcome of 639 victims with acute renal problems during the catastrophic Marmara earthquake have been the subject of this study. Methods: Questionnaires regarding information about 63 clinical and laboratory variables were sent to 35 reference hospitals that treated the victims. Information considering therapeutic interventions and outcome obtained through these questionnaires was submitted to analysis. Results: At least one form of renal replacement therapy was administered to 477 (74.6%) of the 639 victims. Of these, 437, 11, and 4 were treated solely by intermittent hemodialysis, continuous renal replacement therapy, and peritoneal dialysis, respectively; 25 victims needed more than one dialysis modality. In total, 5,137 hemodialysis sessions were performed. Also, 2,981, 2,837 and 2,594 units of blood, fresh frozen plasma, and human albumin were administered, respectively. Transfusion of these products was usually associated with higher rates of dialysis needs and mortality. Ninety-seven patients (15.2%) died. The mortality rate of dialyzed victims was higher as compared to nondialyzed ones (17.2 vs. 9.3%, p = 0.015). Conclusions: Massive amounts of dialysis treatment as well as blood and blood product transfusions can be necessary in the treatment of catastrophic earthquake victims with nephrological problems. Despite the potential risk of a high mortality, in the case of appropriate and energetic medical interventions, reasonable final outcomes can be achieved.

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          Most cited references 4

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          Prevention of acute renal failure in traumatic rhabdomyolysis.

          Following the collapse of a building, seven subjects (aged 18 to 41 years) were released from under the rubble within one to 28 hours. All seven suffered from extensive crush injuries with evidence of severe rhabdomyolysis and were treated by the induction of an alkaline solute diuresis immediately on their extrication from the debris. The leakage of muscle constitutents was estimated by quantifying the net total body potassium losses, which averaged 395 mEq (SD, +/- 198) over the first 60 hours of therapy. In the past, injuries of similar severity have been associated with a high incidence of acute renal failure and a high mortality rate, yet none of our patients had azotemia or renal failure. We attribute this success to the unprecedented early institution of appropriate therapy.
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            Continuous hemofiltration in the treatment of acute renal failure.

             P K Hilton,  L Forni (1997)
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              HIV-associated respiratory diseases

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                Author and article information

                Journal
                NEF
                Nephron
                10.1159/issn.1660-8151
                Nephron
                S. Karger AG
                1660-8151
                2235-3186
                2002
                September 2002
                14 August 2002
                : 92
                : 1
                : 64-71
                Affiliations
                aLocal coordinator for the Renal Disaster Relief Task Force of the International Society of Nephrology (ISN), Department of Nephrology, Istanbul School of Medicine, Istanbul, bPresident of the Turkish Society of Nephrology, Department of Nephrology, Cerrahpasa School of Medicine, Istanbul, Turkey; cRenal Disaster Relief Task Force, Renal Division, University Hospital, Ghent, Belgium; dDepartment of Nephrology, Marmara School of Medicine, Istanbul, eDepartment of Nephrology, Uludag School of Medicine, Bursa, fDepartment of Nephrology, Göztepe Social Security Hospital, Istanbul, gDepartment of Nephrology, Istanbul School of Medicine, Istanbul, hDepartment of Nephrology, Cerrahpasa School of Medicine, Istanbul, iDepartment of Internal Medicine, Bursa State Hospital, Bursa, jDepartment of Nephrology, Baskent School of Medicine, Ankara, Turkey; kRenal Disaster Relief Task Force, Department of Nephrology, Charité-Virchow Clinic, Berlin, Germany; lChairman, Renal Disaster Relief Task Force, European Branch, University Hospital, Ghent, Belgium
                Article
                64487 Nephron 2002;92:64–71
                10.1159/000064487
                12187086
                © 2002 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 2, Tables: 1, References: 28, Pages: 8
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/64487
                Categories
                Original Paper

                Cardiovascular Medicine, Nephrology

                Marmara earthquake, Outcome, Dialysis, Crush syndrome

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