Kidney Res Clin Pract  
Disaster preparedness for earthquakes in hemodialysis units in Gyeongju and Pohang, South Korea
Kyung Don Yoo1,2, Hyo Jin Kim1,2, Yunmi Kim2, Jae Yoon Park1,3, Sung Joon Shin1,3, Seung Hyeok Han4, Dong Ki Kim5,6, Chun Soo Lim5,7, Yon Su Kim5,6
1Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
2Department of Internal Medicine, Dongguk University Gyeongju Hospital, Gyeongju, Korea
3Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
6Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
7Division of Nephrology, Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
Correspondence to: Yon Su Kim
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongnogu, Seoul 03080, Korea. E-mail: yonsukim@snu.ac.kr
ORCID: https://orcid.org/0000-0003-3091-2388
Received: June 14, 2018; Revised: October 29, 2018; Accepted: November 1, 2018; Published online: February 18, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
In 2016 and 2017, there were earthquakes greater than 5.0 in magnitude on the Korean Peninsula, which has previously been considered an earthquake-free zone. Patients with chronic kidney disease are particularly vulnerable to earthquakes, as the term “renal disaster” suggests. In the event of a major earthquake, patients on hemodialysis face the risk of losing maintenance dialysis due to infrastructure disruption. In this review, we share the experience of an earthquake in Pohang that posed a serious risk to patients on hemodialysis. We review the disaster response system in Japan and propose a disaster preparedness plan with respect to hemodialysis. Korean nephrologists and staff in dialysis facilities should be trained in emergency response to mitigate risk from natural disasters. Dialysis staff should be familiar with the action plan for natural disaster events that disrupt hemodialysis, such as outages and water treatment system failures caused by earthquakes. Patients on hemodialysis also need to be educated about disaster preparedness. In the event of a disaster situation that results in dialysis failure, patients need to know what to do. At the local and national government level, long-term preparations should be made to handle renal disaster and patient safety logistics. Moreover, Korean nephrologists should also be prepared to manage cardiovascular disease and diabetes in disaster situations. Further evaluation and management of social and national disaster preparedness of hemodialysis units to earthquakes in Korea are needed.
Keywords: Disasters, Earthquakes, Renal dialysis, South Korea


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