Dialysis in crisis: Delivering renal replacement therapy in disasters, conflicts, and resource-constrained settings

Access to dialysis during crises such as natural disasters, armed conflicts, pandemics, or in low-resource settings remains a significant global challenge. Vulnerable populations requiring chronic or acute dialysis are disproportionately affected by disruptions in infrastructure, supply chains, human resources, and water or power availability. This article explores the operational, clinical, ethical, and logistical challenges faced while delivering dialysis in crisis scenarios. Drawing from global case studies including earthquakes in Japan, war zones in Gaza, water-stressed regions, and lessons from the COVID-19 pandemic, this paper highlights feasible models of care, outlines adaptive strategies, and proposes a framework to improve dialysis delivery during emergencies.