Abstract
KEY POINTS: Disasters cause significant human suffering, and patients with kidney diseases are uniquely vulnerable. We have developed a roadmap for disaster preparedness, response, and recovery by reviewing and synthesizing existing literature. Our roadmap provides an easily implementable approach for kidney care programs to develop context-specific protocols. BACKGROUND: Natural, technological, and other disasters cause significant human suffering, and kidney patients are uniquely vulnerable. The safe provision of KRTs necessitates the consistent provision of resources. Robust disaster risk reduction and management (DRRM) can mitigate risks associated with resource disruption. Individual kidney care programs may benefit from an organized approach to developing context-specific protocols. We aimed to synthesize contemporary literature in kidney care to create a roadmap in DRRM. METHODS: We conducted a scoping review followed by a content analysis using the Framework Method. Literature that focused on lessons learned and proposed strategies or recommendations in DRRM was eligible. We contextualized this roadmap within the domains of disaster preparedness, response, and recovery. RESULTS: Of 3973 titles and abstracts screened, 52 articles were included. We developed the following roadmap: (1) the “ABC(4)s” of disaster preparedness: assess needs, risks, and vulnerabilities (regional risks and patients at risk); build a task force network; capacity building (tangible resources, intangible resources, monetary considerations, and transportation); communication (network and protocol, patients' medical and dialysis information, contact information of all stakeholders, inclusive approach, and reliable medium); coaching (patients, caregivers, health care personnel, and reinforce and repeat); contingency planning (surge capacity, rationing care, and resource distribution); and strategic partnerships. (2) The DIAL response: damage and scope assessment; initiate action plan (choose the plan, apply preparedness tenets, and implications for receiving facilities); appraise the action plan regularly (reassess, maintain ethical standards, and address psychosocial needs); and liaise, engage, and update. (3) The ARC to recovery: assess damage; return to the (new) norm; and collect data to evaluate, improve, and share. CONCLUSIONS: We propose a roadmap to disaster preparedness, response, and recovery that can guide individual kidney care programs globally to develop context-specific protocols aimed at building capacities and facilitating processes toward DRRM. PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2025_06_25_ASN0000000635.mp3