diff --git a/backend/run_all_migrations.js b/backend/run_all_migrations.js
new file mode 100644
index 0000000..3610cfd
--- /dev/null
+++ b/backend/run_all_migrations.js
@@ -0,0 +1,171 @@
+#!/usr/bin/env node
+
+/**
+ * Comprehensive migration runner for RENALGUARD
+ * Runs all migrations in order, tracking which have been applied
+ *
+ * Usage: node run_all_migrations.js
+ */
+
+import pg from 'pg';
+import fs from 'fs';
+import path from 'path';
+import { fileURLToPath } from 'url';
+
+const { Pool } = pg;
+const __filename = fileURLToPath(import.meta.url);
+const __dirname = path.dirname(__filename);
+
+// Database connection from environment
+const DATABASE_URL = process.env.DATABASE_URL;
+
+if (!DATABASE_URL) {
+  console.error('❌ DATABASE_URL environment variable is not set');
+  console.log('Please set DATABASE_URL or source your .dev.vars file:');
+  console.log('  source .dev.vars && node run_all_migrations.js');
+  process.exit(1);
+}
+
+console.log('🔌 Connecting to database...');
+console.log(`   Host: ${DATABASE_URL.match(/@([^/]+)/)?.[1] || 'unknown'}`);
+
+const pool = new Pool({
+  connectionString: DATABASE_URL,
+  ssl: { rejectUnauthorized: false }
+});
+
+async function ensureMigrationTable(client) {
+  await client.query(`
+    CREATE TABLE IF NOT EXISTS schema_migrations (
+      id SERIAL PRIMARY KEY,
+      migration_name VARCHAR(255) UNIQUE NOT NULL,
+      applied_at TIMESTAMP DEFAULT CURRENT_TIMESTAMP
+    );
+  `);
+}
+
+async function getAppliedMigrations(client) {
+  const result = await client.query(
+    'SELECT migration_name FROM schema_migrations ORDER BY migration_name'
+  );
+  return new Set(result.rows.map(row => row.migration_name));
+}
+
+async function runMigrations() {
+  const client = await pool.connect();
+
+  try {
+    console.log('✓ Connected to database\n');
+
+    // Ensure migration tracking table exists
+    await ensureMigrationTable(client);
+
+    // Get already applied migrations
+    const appliedMigrations = await getAppliedMigrations(client);
+    console.log(`📋 Found ${appliedMigrations.size} previously applied migrations\n`);
+
+    // Get all migration files
+    const migrationsDir = path.join(__dirname, '..', 'infrastructure', 'postgres', 'migrations');
+    const files = fs.readdirSync(migrationsDir)
+      .filter(f => f.endsWith('.sql'))
+      .sort((a, b) => {
+        // Extract numeric prefix for proper ordering
+        const numA = parseInt(a.match(/^(\d+)/)?.[1] || '0');
+        const numB = parseInt(b.match(/^(\d+)/)?.[1] || '0');
+        return numA - numB;
+      });
+
+    console.log(`📁 Found ${files.length} migration files\n`);
+
+    let applied = 0;
+    let skipped = 0;
+    let failed = 0;
+
+    for (const file of files) {
+      const migrationName = file.replace('.sql', '');
+
+      // Skip if already applied
+      if (appliedMigrations.has(migrationName)) {
+        console.log(`⏭️  Skipping: ${file} (already applied)`);
+        skipped++;
+        continue;
+      }
+
+      const migrationPath = path.join(migrationsDir, file);
+      const sql = fs.readFileSync(migrationPath, 'utf8');
+
+      console.log(`\n🚀 Running: ${file}`);
+
+      try {
+        await client.query('BEGIN');
+
+        // Execute migration
+        await client.query(sql);
+
+        // Record migration
+        await client.query(
+          'INSERT INTO schema_migrations (migration_name) VALUES ($1) ON CONFLICT (migration_name) DO NOTHING',
+          [migrationName]
+        );
+
+        await client.query('COMMIT');
+        console.log(`   ✅ Success`);
+        applied++;
+
+      } catch (error) {
+        await client.query('ROLLBACK');
+        console.log(`   ❌ Failed: ${error.message}`);
+
+        // For non-critical errors like "already exists", continue
+        if (error.message.includes('already exists') ||
+            error.message.includes('duplicate key')) {
+          console.log(`   ⚠️  Object already exists, marking as applied`);
+          await client.query(
+            'INSERT INTO schema_migrations (migration_name) VALUES ($1) ON CONFLICT (migration_name) DO NOTHING',
+            [migrationName]
+          );
+          applied++;
+        } else {
+          failed++;
+          // Continue with other migrations instead of stopping
+          console.log(`   ⚠️  Continuing with remaining migrations...`);
+        }
+      }
+    }
+
+    console.log('\n' + '='.repeat(50));
+    console.log('📊 Migration Summary:');
+    console.log(`   ✅ Applied:  ${applied}`);
+    console.log(`   ⏭️  Skipped:  ${skipped}`);
+    console.log(`   ❌ Failed:   ${failed}`);
+    console.log('='.repeat(50) + '\n');
+
+    // Verify tables
+    console.log('📋 Verifying key tables...\n');
+
+    const tableCheck = await client.query(`
+      SELECT table_name
+      FROM information_schema.tables
+      WHERE table_schema = 'public'
+        AND table_type = 'BASE TABLE'
+      ORDER BY table_name;
+    `);
+
+    console.log('Tables created:');
+    tableCheck.rows.forEach(row => {
+      console.log(`   ✓ ${row.table_name}`);
+    });
+
+    console.log('\n✅ Migration process complete!');
+
+  } catch (error) {
+    console.error('\n❌ Fatal error:', error.message);
+    process.exit(1);
+  } finally {
+    client.release();
+    await pool.end();
+  }
+}
+
+// Run migrations
+runMigrations();
diff --git a/scripts/run_all_migrations.js b/scripts/run_all_migrations.js
new file mode 100644
index 0000000..29f34e3
--- /dev/null
+++ b/scripts/run_all_migrations.js
@@ -0,0 +1,171 @@
+#!/usr/bin/env node
+
+/**
+ * Comprehensive migration runner for RENALGUARD
+ * Runs all migrations in order, tracking which have been applied
+ *
+ * Usage: node scripts/run_all_migrations.js
+ */
+
+import pg from 'pg';
+import fs from 'fs';
+import path from 'path';
+import { fileURLToPath } from 'url';
+
+const { Pool } = pg;
+const __filename = fileURLToPath(import.meta.url);
+const __dirname = path.dirname(__filename);
+
+// Database connection from environment
+const DATABASE_URL = process.env.DATABASE_URL;
+
+if (!DATABASE_URL) {
+  console.error('❌ DATABASE_URL environment variable is not set');
+  console.log('Please set DATABASE_URL or source your .dev.vars file:');
+  console.log('  source backend/.dev.vars && node scripts/run_all_migrations.js');
+  process.exit(1);
+}
+
+console.log('🔌 Connecting to database...');
+console.log(`   Host: ${DATABASE_URL.match(/@([^/]+)/)?.[1] || 'unknown'}`);
+
+const pool = new Pool({
+  connectionString: DATABASE_URL,
+  ssl: { rejectUnauthorized: false }
+});
+
+async function ensureMigrationTable(client) {
+  await client.query(`
+    CREATE TABLE IF NOT EXISTS schema_migrations (
+      id SERIAL PRIMARY KEY,
+      migration_name VARCHAR(255) UNIQUE NOT NULL,
+      applied_at TIMESTAMP DEFAULT CURRENT_TIMESTAMP
+    );
+  `);
+}
+
+async function getAppliedMigrations(client) {
+  const result = await client.query(
+    'SELECT migration_name FROM schema_migrations ORDER BY migration_name'
+  );
+  return new Set(result.rows.map(row => row.migration_name));
+}
+
+async function runMigrations() {
+  const client = await pool.connect();
+
+  try {
+    console.log('✓ Connected to database\n');
+
+    // Ensure migration tracking table exists
+    await ensureMigrationTable(client);
+
+    // Get already applied migrations
+    const appliedMigrations = await getAppliedMigrations(client);
+    console.log(`📋 Found ${appliedMigrations.size} previously applied migrations\n`);
+
+    // Get all migration files
+    const migrationsDir = path.join(__dirname, '..', 'infrastructure', 'postgres', 'migrations');
+    const files = fs.readdirSync(migrationsDir)
+      .filter(f => f.endsWith('.sql'))
+      .sort((a, b) => {
+        // Extract numeric prefix for proper ordering
+        const numA = parseInt(a.match(/^(\d+)/)?.[1] || '0');
+        const numB = parseInt(b.match(/^(\d+)/)?.[1] || '0');
+        return numA - numB;
+      });
+
+    console.log(`📁 Found ${files.length} migration files\n`);
+
+    let applied = 0;
+    let skipped = 0;
+    let failed = 0;
+
+    for (const file of files) {
+      const migrationName = file.replace('.sql', '');
+
+      // Skip if already applied
+      if (appliedMigrations.has(migrationName)) {
+        console.log(`⏭️  Skipping: ${file} (already applied)`);
+        skipped++;
+        continue;
+      }
+
+      const migrationPath = path.join(migrationsDir, file);
+      const sql = fs.readFileSync(migrationPath, 'utf8');
+
+      console.log(`\n🚀 Running: ${file}`);
+
+      try {
+        await client.query('BEGIN');
+
+        // Execute migration
+        await client.query(sql);
+
+        // Record migration
+        await client.query(
+          'INSERT INTO schema_migrations (migration_name) VALUES ($1) ON CONFLICT (migration_name) DO NOTHING',
+          [migrationName]
+        );
+
+        await client.query('COMMIT');
+        console.log(`   ✅ Success`);
+        applied++;
+
+      } catch (error) {
+        await client.query('ROLLBACK');
+        console.log(`   ❌ Failed: ${error.message}`);
+
+        // For non-critical errors like "already exists", continue
+        if (error.message.includes('already exists') ||
+            error.message.includes('duplicate key')) {
+          console.log(`   ⚠️  Object already exists, marking as applied`);
+          await client.query(
+            'INSERT INTO schema_migrations (migration_name) VALUES ($1) ON CONFLICT (migration_name) DO NOTHING',
+            [migrationName]
+          );
+          applied++;
+        } else {
+          failed++;
+          // Continue with other migrations instead of stopping
+          console.log(`   ⚠️  Continuing with remaining migrations...`);
+        }
+      }
+    }
+
+    console.log('\n' + '='.repeat(50));
+    console.log('📊 Migration Summary:');
+    console.log(`   ✅ Applied:  ${applied}`);
+    console.log(`   ⏭️  Skipped:  ${skipped}`);
+    console.log(`   ❌ Failed:   ${failed}`);
+    console.log('='.repeat(50) + '\n');
+
+    // Verify tables
+    console.log('📋 Verifying key tables...\n');
+
+    const tableCheck = await client.query(`
+      SELECT table_name
+      FROM information_schema.tables
+      WHERE table_schema = 'public'
+        AND table_type = 'BASE TABLE'
+      ORDER BY table_name;
+    `);
+
+    console.log('Tables created:');
+    tableCheck.rows.forEach(row => {
+      console.log(`   ✓ ${row.table_name}`);
+    });
+
+    console.log('\n✅ Migration process complete!');
+
+  } catch (error) {
+    console.error('\n❌ Fatal error:', error.message);
+    process.exit(1);
+  } finally {
+    client.release();
+    await pool.end();
+  }
+}
+
+// Run migrations
+runMigrations();