Regional Symposium (JSDT / Resiliance)
Symposium Introduction
This regional symposium, jointly organized by JSDT and TSDT, brings together clinicians and engineers from Vietnam, Taiwan, and Japan to examine how nephrology and critical care practice adapt when resources, infrastructure, or circumstances are not ideal. Opening remarks by Prof. Wen-Chin Li set the stage for four sessions that move from acute extracorporeal therapy to long-term environmental risk, and then to the technology and coordination needed to sustain kidney care during disasters. The program is designed for nephrologists, intensivists, and dialysis unit staff seeking a practical, experience-based view of extracorporeal support and disaster preparedness that goes beyond routine outpatient care.
The morning begins with Prof. Do Ngoc Son's account of Vietnam's growing experience with extracorporeal carbon dioxide removal (ECCO₂R) in acute hypercapnic respiratory failure, highlighting how the therapy's overlap with continuous renal replacement platforms gives nephrologists a natural role in its safe use, even where trained staff and dedicated equipment are limited. Dr. Kai-Fan Tsai then turns to novel renal biomarkers such as KIM-1, interleukin-18, and gelsolin, tracing their value in detecting kidney injury earlier than creatinine alone, and connecting this to research on environmental nephrotoxicity from exposures such as cadmium and organophosphate flame retardants.
After a coffee break, the focus shifts to disaster-oriented renal care. Prof. Kenichi Kokubo discusses how dialysis technology is evolving to serve two very different needs: precise support for unstable ICU patients and portable, infrastructure-independent systems for disaster response, drawing on Japan's earthquake experience. Prof. Takeshi Moriguchi completes the picture with Japan's Disaster Medical Assistance Team (DMAT) framework, showing how hospital resilience planning and inter-facility coordination sustain ICU-based renal support when normal infrastructure is disrupted.
Prof. Lung-Chih Li closes the symposium by drawing these threads together, from acute extracorporeal support and biomarker-based risk assessment to the hardware and coordination that keep blood purification available under crisis conditions.
| Time | Session |
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08:30
09:20
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Room 2
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09:20
10:15
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Room 2
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10:15
10:45
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10:45
11:30
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Kenichi Kokubo
Speaker
Developing Next-Generation Dialysis Technologies for Acute Kidney Care and Disaster Preparedness
Room 2
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11:30
12:15
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Takeshi Moriguchi
Speaker
Blood Purification in Disasters: Japan’s Evolving Approach to Hospital Resilience, DMAT Coordination, and ICU-Based Renal Support[Background]
Disasters markedly increase the incidence of acute kidney injury (AKI) while simultaneously disrupting the critical lifelines required to deliver renal support. In Japan, most maintenance dialysis patients receive treatment in outpatient clinics rather than large hospitals. During major disasters, including the Noto Peninsula earthquake, the status of affected dialysis facilities and the number of patients requiring treatment were rapidly assessed. Dialysis networks allocated patients based on receiving capacity and arranged transfers outside the affected area when necessary. This demonstrates that disaster renal care relies as much on logistics, information sharing, and regional coordination as it does on dialysis techniques.
[Acute Care & Resource Requirements]
Acute renal replacement therapy for critically ill patients is typically provided in large hospitals and consumes substantial resources. Patients presenting with crush syndrome, rhabdomyolysis, trauma, shock, sepsis, heat-related illness, or multiple organ failure may require intermittent hemodialysis (IHD), prolonged intermittent renal replacement therapy (PIRRT), or continuous renal replacement therapy (CRRT). These therapies strictly depend on electricity, water, replacement fluids, circuits, filters, catheters, anticoagulants, and trained medical staff. Prompt diagnosis, triage, and timely transfer to hospitals capable of acute blood purification are essential to effective disaster response.
[Systems & DMAT Integration]
This lecture highlights Japan’s evolving approach to disaster blood purification, developed through repeated experiences with earthquakes, tsunamis, floods, and other emergencies. Particular emphasis is placed on Disaster Base Hospitals, which are expected to maintain emergency functions through earthquake-resistant infrastructure, backup power, water supplies, medical stockpiles, robust communication networks, business continuity planning (BCP), and specialized personnel. Additionally, the role of Disaster Medical Assistance Teams (DMAT) will be discussed in evaluating hospital capabilities, supporting affected facilities, coordinating patient transport, and bridging field medicine with ICU-capable facilities.
[Conclusions]
From an ICU perspective, disaster blood purification requires a delicate balance between physiological benefit and logistical feasibility. Continuous therapies (CRRT) should be reserved for hemodynamically unstable patients requiring ongoing support, whereas intermittent therapies (IHD/PIRRT) are preferable when rapid correction of hyperkalemia or acidosis is needed, or when resources are limited. Ultimately, blood purification in disasters is a system-dependent form of organ support: a CRRT machine is only as strong as the hospital and regional lifelines behind it.
Room 2
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12:20
12:30
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