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Joint Statement from ASN, ERA, and ISN: Global Kidney Organizations Appeal for Kidney Health for All War Victims

Thursday, March 10, 2022

As we observe World Kidney Day 2022 and recognize all the incredible advances in our field, we must pause and remember members of the kidney community in war-torn countries. This year’s World Kidney Day theme, “Kidney Health for All,” underscores harsh inequities that currently exist around the world. Global attention is currently on the war in Ukraine; many other countries-such as Afghanistan, Cameroon, Ethiopia, Iraq, Libya, Sudan, Syria, and Yemen-are also in conflict.

The American Society of Nephrology (ASN), the European Renal Association (ERA), and the International Society of Nephrology (ISN) condemn the shocking invasion of Ukraine by Russia, and we express our concern for the health and safety of all people, including those with kidney diseases, kidney failure, and kidney transplants in Ukraine, its neighboring countries, and other countries worldwide affected by armed conflict.

More than 850 million people worldwide live with kidney diseases, including an estimated 10,000 people in Ukraine who depend on dialysis to live. “The global kidney community-including ASN, ERA, and ISN—thank the many companies and organizations that are continuing to provide kidney care in war zones, donating medicines and equipment, and supporting nephrologists and other health professionals in very challenging circumstances,” said ISN President Agnes B. Fogo, MD. “ASN, ERA, and ISN urge other companies, organizations, and the governments of the world to do more for the people with kidney diseases in Ukraine, its neighbors, and other war-torn countries.”
Millions of people with healthy kidneys are at risk for acute kidney injury due to crush injuries from bombings and other unfortunate realities of war. People with acute kidney injury often require hospitalization and dialysis to survive. If they do not receive this care as soon as possible, kidney function may not return, and they might die.

Dialysis requires a safe space for treatment, intact electricity and water supply, and medical staff to administer facility-based treatments. People with kidney failure who receive dialysis require these life-sustaining treatments several times a week. Any interruption of this schedule endangers their lives. Even if they miss one or two treatments, these patients could experience life-threatening complications or sudden death.

In addition, thousands of people living in conflict zones worldwide have had kidney transplants and require daily treatment with immunosuppressive medicines. If they fail to take these medicines, people with kidney transplants risk rejection by their transplanted kidneys, loss of these kidneys, and life-threatening illness. For example, if Ukrainians with kidney transplants lose their kidney function, they would join 10,000 of their compatriots in requiring dialysis.

“People with kidney failure and kidney transplants urgently need to find alternatives, because wars are destroying dialysis facilities, interrupting energy and water supplies, causing medical staff shortages, and making travel to facilities unsafe,” added ASN President Susan E. Quaggin, MD, FASN. “As we mark World Kidney Day 2022 and the many amazing advances in kidney health, ASN, ERA, and ISN must also condemn the war in Ukraine, express our concern for kidney patients and their caregivers who are in harm’s way, thank the companies and organizations that have already contributed aid, commend the countries that have opened their borders to receive people in need, and urge governments to do more.”

When people with kidney failure flee from dangerous areas, they must immediately find dialysis facilities that are functioning, safe from the ravages of war, and can accommodate them. Governments and other stakeholders must help them overcome these major challenges, even as their needs shift and change each day in emergency situations as now exist for millions of people worldwide.

“On World Kidney Day 2022, Kidney Health for All must include the people of Ukraine, its neighbors, and other countries affected by war,” said ERA President Christoph Wanner, MD. “Even though ASN, ERA, and ISN are non-political medical specialty societies, we call for an end to the unilateral violation of international rules in Ukraine and urge a return to dialogue and mediation to achieve a rapid resolution of the crisis. We also stand in solidarity with the world’s nephrologists and other health care professionals.”

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