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involve the patient in kidney therapy

Dialysis is the therapy that replaces kidney function when it fails. A chronic treatment that requires more personalized care for the patient and their active role in decision-making. On World Kidney Day, let’s talk about humanizing dialysis.

Putting the focus on prevention and early diagnosis and empowering patients and relatives in care are some of the factors for the humanization of dialysis, a therapy for the kidney that will accompany the affected person for years.

This is the goal for dialysis that pursues the Spanish Society of Nephrology (SEN), the ALCER Federation and Fresenius Medical Care joined the campaign “Leave a mark for your kidney health” on the occasion of World Kidney Day, March 9.

The initiative emphasizes being aware of the measures to prevent kidney disease, but also of the tools that exist for everyone to contribute knowledge to the achievement of a more humanized dialysis, making known this therapy, its advances and the needs of patients and relatives.

What is kidney dialysis?

In 2021, new cases of chronic kidney disease increased by almost 7%, according to data from the SEN, and 7,084 people began receiving kidney replacement treatment with dialysis or transplantation, which means, if the previous cases are added, that in Spain there are 65,740 people with this treatment, 46% receiving dialysis therapy.

Although thousands of people start receiving dialysis each year, there is still a great deal of ignorance about this therapy that is used to filter the blood of toxins, unwanted waste and excess body fluids.

If a machine is used to extract and filter the blood it is called hemodialysisbut if this process is done through the peritoneum, a cavity located in the abdomen, it is peritoneal dialysis.

The patient can perform these two types of dialysis at home (home dialysis) or, if he prefers and adapts better, go to a hemodialysis center (in-center dialysis).

“The patient is the one who decides what type of treatment he incorporates into his life. This active role does not end here, in this decision, but it is essential to count on it throughout the treatment, which is chronic, because their involvement and that of their family/carers will be fundamental in their evolution”, he explains Eva Baró, medical director of FME.

For the doctor Patricia de Sequera, president of the Spanish Society of Nephrology (SEN), “improving care for kidney patients requires that society is well informed about this disease, knows how to detect it and the habits that keep the kidney healthy”.

“But also – he adds – initiatives that improve patients’ quality of life are fundamental, and this is where the humanization of processes comes into play, allowing for quality care and a comprehensive approach to the patient at all levels.”

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The face and cross of technology

An excessive technicization of medicine can make patients and their families feel left out of decision-making in treatment, according to the sources mentioned.

However, thanks to technical advances, today’s dialysis is much more effective and comfortable compared to years ago and also allows the development of dialysis systems that free up the healthcare professional and allow him to devote more time to the treatment with the patient

“We have devices that give us security and reliability, but the patient needs much more than what a dialysis machine gives us. We have needs that go beyond the physical part, and that go through more human aspects such as emotional, social, nutritional and economic”, he points out Daniel Gallego, president of the ALCER Federation.

For this reason, the humanization of dialysis must be part of the ecosystem of processes that are carried out around the kidney patient.

Hemodialysis units are highly technical places with complex machines that could mechanize care but can also undermine the quality of care and patient well-being.

One of the examples for integrating the patient is taking their opinion into account in a systematic way.

Dialysis and malnutrition

On the other hand, the EMID studycarried out in 52 dialysis units throughout Spain, reveals that more than half of the patients with chronic kidney disease on dialysis are malnourished.

This research, coordinated by the doctor Guillermina Barril, head of the Nephrology section at the La Princesa University Hospital in Madrid and the support of the company Nutricia, has had the participation of 2,748 hemodialysis patients and 189 peritoneal dialysis patients from Spanish centers.

The results show that 50.6% of these patients have malnutrition, of which 20.5% is moderate, severe (18.6%) and extreme (11.5%).

In addition, it has been seen that 38.3% are at risk of malnutrition and only 11% of patients are nourished in normal parameters.

Research has also shown that the prevalence of malnutrition is greater in men and in older people.

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