Natural mass disasters directly or indirectly affect huge populations, who need basic infrastructural help and assistance to survive. However, despite the potentially negative impact on survival chances, the authorities often dismiss these health care issues.
This impact is of great importance, especially in the emerging world, where the casualty rates are much higher because of inappropriate building materials and lack of appropriate construction standards. Thus, massive destruction can occur with earthquakes of even moderately low magnitude.
The first description of the crush syndrome appeared in the modern medical literature after the Messina earthquake in 1909. Since crush syndrome is quite rare in daily practice, mistakes are frequent in treating these cases.
This review summarizes the etiopathogenesis of traumatic rhabdomyolysis and crush syndrome based acute kidney injury. The clinical and laboratory features, prophylaxis, and treatment of crush cases are described as well.
The importance of early and dynamic fluid resuscitation is indicated for the prophylaxis of acute kidney injury. Treatment of both acute and chronic kidney diseases (CKDs) is especially problematic after disasters because they almost always require complex technology and equipment, whereas specific drugs may be difficult to obtain to treat chronic kidney patients.
Although crush syndrome is a major cause of mortality in the rescued victims of massive earthquakes, the number of deaths due to crush syndrome (or fatalities of renal disaster) can be decreased by appropriate management.
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