[Decision making among older adults in hemodialysis. A qualitative assessment].

Background: In Chile there are 22,310 people in Chronic Hemodialysis (CHD), 53% of them older adults (OA). Shared decision-making and advance directives (AD) are especially important in OA with end-stage chronic renal failure, since they have greater levels of disability, morbidity and mortality, raising doubts about the benefit of therapy.

Aims: To understand the experience in decision making and explore ways to express AD, in OA in CHD.

Antimicrobial lock solutions for preventing catheter-related infections in haemodialysis.

Background: Patients undergoing haemodialysis (HD) through a central venous catheter (CVC) are exposed to several risks, being a catheter-related infection (CRI) and a CVC lumen thrombosis among the most serious. Standard of care regarding CVCs includes their sealing with heparin lock solutions to prevent catheter lumen thrombosis. Other lock solutions to prevent CRI, such as antimicrobial lock solutions, have proven useful with antibiotics solutions, but not as yet for non-antibiotic antimicrobial solutions.

[Nurses' workload in hemodialysis units].

Background: Knowing nurses' workload in hemodialysis units allows a better organization of human resources.

Aim: To determine nurses' workload according to dependence and risk profiles of patients undergoing chronic hemodialysis.

Material And Methods: One hundred fifty one patients from five hemodialysis units were selected and categorized in terms of dependence and risk using the instrument "Care according to dependence and risk in hemodialysis (CUDYR-DIAL).

[Conflicts of interest in nephrology].

Since doctors disposed of effective tools to serve their patients, they had to worry about the proper management of available resources and how to deal with the relationship with the industry that provides such resources. In this relationship, health professionals may be involved in conflicts of interest that they need to acknowledge and learn how to handle. This article discusses the conflicts of interest in nephrology.

Translation and adaptation to Portuguese of the haemodialysis patient assessment tool - CUDYR-DIAL.

Objective To translate and culturally adapt the tool Categorización de usuario según dependencia y riesgo en unidades de hemodiálisis (CUDYR-DIAL) into Brazilian Portuguese. Method This is a methodological study for the translation and cultural adaptation or localization of the instrument CUDYR-DIAL. Results In the pre-test stage, three nurses applied the instrument to 78 patients of the haemodialysis unit of the São Lucas Hospital of the Pontifícia Universidade Católica do Rio Grande do Sul.

[Ethical issues perceived by health care professionals working in chronic hemodialysis centers].

Background: Clinical teams working at chronic hemodialysis centers (CHC) frequently have to face ethical problems, but there is no systematic approach to deal with them.

Aim: To study the ethical problems perceived by health professionals at CHC.

Material And Methods: Eighty randomly selected physicians and 139 nurses from 23 CHC, answered a structured questionnaire, devised by the research team.

[Recommendations of the Ethics Committee of the Chilean Society of Nephrology for the management of ethical problems in adult end stage renal disease patients].

There are different approaches to treat patients with End Stage Renal Disease (ESRD): hemodialysis, peritoneal dialysis, renal transplantation and conservative medical management. The choice of the best therapy for each patient, needs both clinical and ethical skills. The Ethics Committee of the Chilean Society of Nephrology has elaborated recommendations to help health workers to deal with the ethical and clinical problems related to patients suffering ESRD.

[Depression and self-perceived burden of care by hemodialysis patients and their caregivers].

Objective: To determine the depressive symptoms, perceived social support, and self-perceived burden in chronic hemodialysis (CHD) patients; identify depressive symptoms and degree of fatigue in caregivers of CHD patients; evaluate-in patients-the association between self-perceived burden and perceived social support, and between self-perceived burden and depressive symptoms; and evaluate-in caregivers-the relationship between the number of years of care and the degree of fatigue reached.

Methods: A sample of 162 patient-caregiver pairs was selected in which an adapted version of the Multidimensional Scale of Perceived Social Support, along with the Self-perceived Burden Scale, the Center for Epidemiologic Studies Depression Scale, and the Fatigue Severity Scale were applied. The instruments were administered to patients by trained research assistants and, in the case of the caregivers, were self-administered.