War in Ukraine and dialysis treatment: human suffering and organizational challenges

Abstract

In January 2021, there were 9,648 patients in Ukraine on kidney replacement therapy, including 8,717 on extracorporeal therapies and 931 on peritoneal dialysis. On 24 February 2022, foreign troops entered the territory of Ukraine. Before the war, the Fresenius Medical Care dialysis network in Ukraine operated three medical centres. These medical centres provided haemodialysis therapy to 349 end stage kidney disease patients. In addition, Fresenius Medical Care Ukraine delivered medical supplies to almost all regions of Ukraine. Even though Fresenius Medical Care's share of end stage kidney disease patients on dialysis is small, a brief narrative account of the managerial challenges that Fresenius Medical Care Ukraine and the clinical directors of the Fresenius Medical Care centres had to face, as well as the suffering of the dialysis population, is a useful testimony of the burden imposed by war on these frail, high-risk patients dependent on a complex technology such as dialysis. The war in Ukraine is causing immense suffering for the dialysis population of this country and has called for heroic efforts from the dialysis personnel. The experience of a small dialysis network treating a minority of dialysis patients in Ukraine is described. Guaranteeing dialysis treatment has been and remains an enormous challenge in Ukraine and we are confident that the generosity and the courage of Ukrainian dialysis staff and international aid will help to mitigate this tragic suffering.

Social and Healthcare Impacts of the Russian-Led Hybrid War in Ukraine – A Conflict With Unique Global Consequences

“…This includes more than 2000 physicians, and 1500 mid-level medical professionals (such as nurses, midwives, paramedics, and pharmacy). 73,74…”

Ukraine’s Healthcare Crisis: Sustainable Strategies for Navigating Conflict and Rebuilding for a Resilient Future

“…As of January 2023, about 45,000 internally displaced medics have found employment in other medical facilities across the country, including more than 2000 physicians, 1500 mid-level medical professionals (nurses, midwives, paramedics, pharmacy assistants), and approximately 800 technical staff. These healthcare professionals are predominantly found in the Cherkasy, Kharkiv, and Poltava regions [11,27]. Interestingly, in certain parts of Ukraine, such as the Zaporizhia, Poltava, and Dnipropetrovsk regions, physicians who left these areas have been 'replaced' by specialists coming from the temporarily occupied areas.…”

One year of the full-scale war in Ukraine and kidney replacement therapy: Where do we stand now? A brief report of the Ukrainian Renal Disaster Relief Committee of the Ukrainian Association of Nephrologists and Kidney Transplant Specialists

“…Before the war, Ukraine had a well-developed system of kidney care, including dialysis and transplantation services [3,4]. However, the war has led to the destruction of many dialysis centers, the widespread displacement of patients, and shortages of personnel and dialysis supplies.…”

“…3 КНП "Київський міський центр нефрології та діалізу", Київ, Україна4 ТОВ «Фрезеніус Медикал Кер Україна», Черкаси, Україна Резюме. Війна в Україні триває вже дев'ятий рік, і минув рік після широкомасштабного вторгнення російської армії в Україну.…”