Chronic Renal Failure
In the world, more people suffer from chronic kidney disease. Common patient education reduces the number of complications, reduces treatment costs and improves patients’ quality of Chronic Renal Failure. Patients are hospitalized less often and have better control the sign symptom of anemia, malnutrition and calcium and phosphate metabolism. Education should be directed not only to patients but also to their families or caregivers who, in the absence of patient independence, play a key role in the treatment process.
Renal replacement therapy
Education of patients with chronic kidney disease should be considered as part of treatment. Patients should be informed as early as possible about possible types of renal replacement therapy in the event of loss of renal function. The patient should be able to make informed decisions about treatment. This reduces the patient’s stress related to the necessity of changes in his life. According to the recommendations of the team of the national nephrology consultant, patient education should be performed regardless of the stage of the disease. Educational content, however, varies depending on the stage of the disease and the method of renal replacement therapy.
Stage of CKD
Information on how to conduct education depending on the stage of CKD was taken from the recommendations of the national nephrology consultant team.
First Stage:
Patients in the first stage of CKD should be informed how often this syndrome occurs and what its consequences are. According to the data presented in the same document, CKD occurs in 10-18% of the population. In risk groups, 50% of people may have this syndrome.
II & III stage
In stage II and III, patients should be familiar with non-pharmacological and pharmacological methods of nephroprotection. The patient and his family should acquire the ability to take care of health.
As a result, the progression of chronic renal failure is slower and complications occur later. It is in these stages that nephroprotection brings the best medical effect. Patients should learn about the factors accelerating the development of CKD and ischemic heart disease. Education should also include knowledge of physical activity, rehabilitation, the need to regularly take medications prescribed by a doctor, and follow a diet.
IV Stage
In the fourth stage of CKD, education includes, in addition to the previously mentioned issues, issues related to renal replacement therapy. The patient should be prepared to consciously choose the therapeutic option. If one of the dialysis methods is not available in a given dialysis center, the patient should be able to be referred to another center that will guarantee it. The treatment of choice is kidney transplantation, preferably from a living related donor.
Stage 5 of CKD
In stage 5 of CKD, i.e. in the period of end-stage Chronic Renal Failure, patients should be educated about complications of dialysis therapy, possibilities of their prevention and early detection. Education should also be performed caring patients after kidney transplantation. The educational content in this case includes the principles of self-control, possible complications, and adherence to the recommendations necessary to obtain good treatment results.
Diet of patients with renal insufficiency
Patients with chronic renal failure should monitor the amount of fluid consumed and excreted. Information on how to maintain a fluid balance comes from the publication “Renal replacement therapy in nursing practice” by B. Rutkowski. The fluid balance of a patient with chronic renal failure should be calculated according to the formula: daily fluid intake = urine output + 500 ml. In peritoneal dialysis patients, we calculate the daily balance according to the following formula: amount of urine output + 500 ml + ultrafiltration (volume of fluid removed by dialysis).
When a patient is on hemodialysis and no longer urinates at all or in trace amounts, the weight gain between dialyses should not be more than 1.5 to 2 kg. A sick person should drink whenever he feels thirsty. If he was in the habit of drinking water without even feeling thirsty, he must give it up. In order not to increase thirst, patients should give up eating highly salted products such as crisps, sticks, salty cheese.
Nurses are mainly involved in the education of Nephrological patients. Educational nurses should be created in the future, especially in large centers. In the article “The role of a nurse in education of a patient with chronic kidney disease” you can find out what rules should be followed in the education of a nephrological patient. In the education process, we can distinguish 5 necessary rules to achieve the intended results. The patient’s participation in the process of both education and care should be partnership-based.
The patient is interested in learning self-care and cooperates willingly with the staff. Another rule is to follow the rules of proper communication. Use language the patient understands and try to avoid strictly medical terms. For the same reason, the choice of content should be rational. Avoid unnecessary medical details and focus on practical content applicable to the patient’s daily life. As in every case, there is a holistic approach to the patient. Treating each patient individually, avoiding schematic treatment is another principle. Each sick person has the right to his own beliefs and to a subjective assessment of health and disease. The patient and his family should be able to ask questions and more difficult issues. Patient education should be completed with a test to check the effect of education
