A 50-year-old patient who was treated in a nephrology clinic since May 2001 for renal failure secondary to polycystosis, presenting with hypertension, dyslipidemia, hyperuricemia and prostatic syndrome.
Dialysis began urgently on October 26, 2007 with a temporary catheter.
A tunneled catheter was implanted and the left radial internal arteriovenous fistula was performed unsuccessfully, so a new attempt was made in the left artery to leave the ring, which did not work, so it was decided to use a tunneled catheter.
The contact of the patient with nursing was when he was admitted due to deterioration of renal function, since the nephrologist referred him to the Advanced Chronic Kidney Disease consultation to inform him of the different options.
In the data collection it was observed that the patient was working in a cake, had the ability to learn and had the support of his wife.
In explaining the different modalities, advantages and disadvantages of each of them, we offered HDDD, but the patient seemed to decline due to CAPD.
We left him some time to assimilate the information, gave him didactic material and informed him about some Internet pages he could read.
After the weekend of reflection, the patient and his wife stated that the technique that would least alter his lifestyle was HDDD, since in this technique he was strict alone for two hours, in his own home and without treatment.
They began to program the educational sessions to which the patient and his wife came.
To this end, we performed a training protocol, which contained in each week the topics to be dealt with, without moving on to the next theme if that of the previous week was not known.
We start with basic knowledge such as meaning of renal failure, dialysis phenomenon, adequate nutrition.
We continue with the importance of daily water control: chlorine, chloramines and hardness.
Subsequently, we passed to the parts of the monitor, preparation, assembly, possible alarms.
Later, we followed the patient's connection, which, as previously mentioned, had a tunnelled catheter, so we explained the importance of a sterile technique.
While the patient was connected, we used to explain the alarms, the most frequent undesirable symptoms during dialysis, and how to minimize them once they were at home.
Finally, we discuss the issue of monitor disinfection.
Meanwhile, at home, the water plant was installed, and the technician and nurse from the commercial house provided the system who were in charge of explaining its operation.
Once installed, a chemical and bacteriological analysis control was carried out, demonstrating the presence of aerobic bacteria / ml of mesophilic germs, which increased the dechlorinating capacity.
A high-resolution camera was also installed to maintain direct contact through videocontape with the patient, allowing us to visualize the catheter opening, the connection form or any other question posed.
