Patients “Trafficked” to the Emergency Department: Renal Failure and Other Effects on the Community Health

Özgür KARCIOĞLU; Serdar OZTORA; Şennaz ŞAHİN; Seçkin Bahar SEZGİN; Uyaris ÇOBAN; Sıla SADILLIOĞLU; Yılmaz AYDIN; Mustafa YAZICIOĞLU

Özgür KARCIOĞLU¹, Serdar OZTORA², Şennaz ŞAHİN², Seçkin Bahar SEZGİN², Uyaris ÇOBAN², Sıla SADILLIOĞLU², Yılmaz AYDIN², Mustafa YAZICIOĞLU²

¹Department Of Emergency Medicine, Acıbadem University, School Of Medicine, İstanbul
²Department Of Emergency Medicine, Bakırkoy Dr. Sadi Konuk Research And Training Hospital, İstanbul

Keywords: Acute prerenal failure, emergency department, human trafficking, malnutrition, volume depletion

Abstract

Introduction: Illegal trafficking of human beings is a social and economic phenomenon which is to be combated seriously. Acute renal failure in trafficked human beings is not common and usually results from prerenal failure.
Case Series: This paper describes a group of illegal immigrants brought into the emergency department (ED) after being arrested by the police as victims of human trafficking. The group consisted of 20 young males around their twenties. They were all dehydrated and malnourished after a long journey allegedly suffered in a truck trailer. Thirteen out of 160 were reportedly dead in the whole group. Vital signs were within normal limits in all. Nine cases were found to be confused on admission, including seven with high renal function test values (BUN and creatinine). Three cases had creatinine levels higher than 4 mEq/L. These cases with acute prerenal failure were aggressively and successfully treated with volume replacement. One patient was admitted to the internal medicine ward, while others were treated in the ED for prerenal failure. Some others were vaccinated against tetanus due to cuts in extremities. After stabilization and proper treatment, the patients recovered within several days and were discharged without any sequelae.
Conclusion: Clinicians should not overlook the possibility of acute prerenal failure resulting from volume depletion and malnutrition in patients subjected to illegal journeys lasting for weeks in the context of trafficking of humans. Aggressive rehydration and other supportive measures are mainstay points in the emergency management.