The majority of the researchers having worked on the psychology-nephrology agree to say that the stake in dialysis patient is lived as a major traumatism. Do we consequently have to understand that the announcement of the renal insufficiency accompanied with a medical follow-up indeed upstream to the stake in dialysis cannot require a preventive value? To arrest various stages in the progress of the person reached by a renal pathology helps us to understand in what way the psychic temporality is different from the real time. Doctors, nursing, psychologists seem sometimes amazed to notice that the patient did not integrate certain elements of reality, cannot hear, accept his condition to be sick whereas he has a crowd of information or what it was "warned". In supporting us of clinical examples, we advance the hypothesis according to which the fistula arterio-venous as first physical burglary seems too to be traumatic. We wonder if between two of the creation of the arterio-venous fistula and the stake in dialysis is a convenient moment to inform the patient and watch that he welcomes as good as possible the treatment.
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