Sharing secrets of the hemodialysis club.

摘要

Patients with end stage renal disease (ESRD) requiring dialysis are frequently hospitalized, and care is provided by registered nurses with-out much knowledge about kidney disease. Some typical conversations that can be overheard in the hospital setting might include the following: Conscientious patient: "Nurse, can I get my PhosLo~R now with my breakfast?" Hurried nurse replies: "In just a minute. I'll bring it with your other medicines. They are ordered for 9:00 a.m." An often noncompliant, thin patient argues, "My doctor said I could eat anything I want to. I want ice cream now!" Nurse smiles and soothes, "Now you know people with kidney disease are supposed to eat less protein. Don't try to pull one over me!" A nurse who is new to the medical- surgical floor says, "You mean I wasn't supposed to give blood pressure medications before hemodialysis? Nobody even told me he was having dialysis today!" For uninitiated nurses, hemodialysis sometimes seems like a special club with its own secret passwords, and patients with ESRD are like club members with few clues to the inner circle. The dialysis process and the management of chronic kidney disease (CKD) and its complications are subject to many misconceptions.