Nephrological care in Ukraine during wartime: challenges and innovations

Abstract

The war in Ukraine has profoundly impacted the provision of nephrological care, presenting numerous challenges while also driving significant innovations. This study aims to analyze the availability and quality of nephrological care in Ukraine during wartime, focusing on chronic kidney disease stages 1–5D/T. The conflict has caused population displacement, restricted access to treatment, and disrupted healthcare logistics, adversely affecting nephrological care. Despite these challenges, the healthcare community has adapted through the implementation of virtual nephrology, incremental and extended dialysis regimens, and increased use of new therapy approaches. The war led to a decrease in the population and migration of medical personnel, particularly from southeastern to western Ukraine, causing staffing imbalances that were gradually addressed. Technological innovations, such as digital nephrobiopsy with immunohistochemical analysis and the use of cloud-based technology, allowed for rapid and remote diagnosis. Virtual healthcare and remote consultations ensured continuity of care, while kidney transplantation activities saw a notable increase, facilitated by advanced techniques and international aid. Despite initial logistical challenges and resource shortages, the resilience and adaptability of the Ukrainian nephrological care system have been evident. This study underscores the importance of robust contingency planning, international collaboration, and the adoption of innovative solutions to maintain healthcare delivery in conflict zones. The findings offer valuable insights into managing nephrological care under extreme conditions and highlight the potential for these innovations to improve care delivery globally.