Introduction

 

Paul Stevens

Consultant Nephrologist & Head of Department, Kent & Canterbury Hospital

 

On Monday 15 April 1912, at 12.30 a.m. in the North Atlantic, near Canada, the RMS Titanic struck an iceberg and sank. Only 745 people were saved but 1595 died. There were many factors that led to this disaster but three are particularly worthy of mention in the context of this symposium. Firstly, despite a general awareness of the danger of icebergs there was no early warning system for this particular iceberg. Secondly, the distress signal used was not the new, internationally agreed “SOS” distress signal but the old “CQD” signal. Thirdly, although in all 28 ships were in communication with the Titanic after it struck the iceberg only one, the Carpathia, rescued all the survivors. For those who have not yet guessed the Renal Medical Services Titanic is in danger of striking the chronic kidney disease iceberg. Do we have any early warning systems? What is the distress signal? Who should be coming to our rescue? How big is the iceberg? What are the consequences of using the correct distress signal? What are the controversies and what are the strategies that will break up the iceberg and render it harmless?