Abstract

ALVAREZ PEREZ, Rosario  and  VELASCO BALLESTERO, Sonia. Nursing predialysis clinic: achievements and opportunities for improvement. Rev Soc Esp Enferm Nefrol [online]. 2007, vol.10, n.3, pp.6-11. ISSN 1139-1375.

Retrospective study reviewing the characteristics and evolution of all incident patients in Segovia, during the period 2000-2005. The main objective was to describe the role of the Predialysis Clinic (PDC) in the selection of the kind of dialysis (hemo or peritoneal), the availability of a functioning access (either a vascular access or a peritoneal catheter) at the beginning of treatment, and in hepatitis B vaccination. We reviewed 123 patients of who 99 started haemodialysis (HD) and 24 Chronic Ambulatory Peritoneal Dialysis (CAPD). 97 patients were seen in the PDC and were followed up for a mean period of 26 months (range 1-126). Of them, 76 started HD and 21 CAPD. At the time of starting hemodialysis, 92% of the patients seen in the PDC had a functioning vascular access and 56,5% of them started as outpatients (not needing hospitalization). At the time of starting CAPD, all 21 patients had a functioning peritoneal catheter and all of them started as outpatients. Twenty two patients had hepatitis B antibodies. 70,6% of the patients no previously inmmunized had received four doses and 20,6% had received at least two doses of hepatitis B vaccination, prior to starting on dialysis. This results shows that PDC improves the attention to patients with Stage 5 Chronic Renal Disease since: it permits to take an informed decision, by the patient and its family, of the preferred kind of dialysis; it facilitates the standardization of follow-up; it permits the timely construction of an adequate vascular access or peritoneal catheter, as well as the complete Hepatitis B vaccination; and, in summary, improves efficiency, diminish morbimortality and preserves patients wellbeing.

Keywords : Predialysis clinic; Haemodialysis; Peritoneal dialysis; Vascular access; Catheter; Vaccination; Treatment election.

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