Earthquakes are mass disasters that are common all over the world. Crush syndrome is the second most common cause of death after trauma in early survivors. More than 46.000 people lost their lives in the 2023 earthquake that took place recently and covered a wide geography in the South and South East Anatolia region of Turkey. The most important causes of acute kidney injury (AKI) during earthquakes are crush injury-induced hypovolemia and myoglobinuria. Therefore, the most effective treatment is to initiate early and energetic intravenous (IV) fluid replacement while the victim is still under the debris. İn this time, nephrotoxic drugs and fluids containing potassium should be avoided. Isotonic sodium chloride (NaCl) is recommended for the prevention of acute kidney injury in disasters, because it is easily available in disasters and is a suitable replacement fluid for volume support. Prerenal, intrarenal and postrenal kidney damage after an earthquake can develop both in the disaster area and in the hospital environment. When preventive measures for acute kidney injury fail, dialysis treatment should be planned for patients with persistent oligo-anuria despite fluid therapy, and patients should be placed on intermittent hemodialysis.