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Managing the activities of the UAN during hostilities is a challenge for doctors and patients themselves. We analyzed the activity of the association since the beginning of the war in Ukraine to formulate further recommendations.
Ukrainian Association of Nephrologists which is an ISN-affiliated society includes nephrologusts, pediatric nephrologists and a patient society, a total of 224 persons at the beginning of the war in Ukraine. It’s a digital society with e-documents, logo-designed credit cards, 2 annual CME courses founded in 2005, a peer-reviewed quarterly nephrology journal, and a modern nephrology clinic.
We used methods of medical statistics and SWOT-analysis with POEM design for recommendations.
Since the beginning of the military conflict, the association has taken upon itself the organization of communication between doctors, nephrology departments and patients to ensure continuity of nephrological care for adults and children. 4 zones were identified depending on the activity of hostilities and the ability to provide assistance based on the logistics of supplying drugs, dialysis consumables, and the number of patients and personnel.
We identified periods that characterized extremely difficult and, on the contrary, more favorable conditions for the provision of nephrological care. The number of people requiring renal replacement therapy in Ukraine decreased by 16-14% from the pre-war level, and the total number of nephrological patients at certain periods decreased by 32-21%.
The most serious challenges came from limited quantities of medications and consumables for dialysis, logistical difficulties in assisting, communication breakdowns, lack of electricity and staff shortages. Positive elements were represented by a large volume of humanitarian aid, admission of refugees for treatment, and professional support from specialized associations.
The existing challenges initiated the intensification of staff work, an increase in the number of transplantations, individualization of renal replacement therapy, implement an incremental dialysis, the use of treatment methods that do not require the constant presence of personnel, active self-education of doctors and patients, and ensuring greater accessibility in communication with doctors using messengers.
Ukrainian association of nephrologists developed recommendations for the provision of nephrological care in conditions of a prolonged military conflict, which are presented in part publications and discussions in the international community. Recommendations are being improved by the changing military situation.