Nursing and wound care in the patient with chronic kidney disease in dialytic treatment

Patients with end stage renal disease on hemodialysis are at high risk of developing skin wounds, especially those secondary to uremia, such as xerosis and pruritus, or to diabetes and vasculopathy. In fact, uremic complications, as metabolic acidosis and alteration of calcium-phosphorus metabolism, and the increased incidence of diabetes and vasculopathy in this population, represent the major risk factors of skin wounds. This problem significantly affects the quality of life of hemodialysis patients, representing a serious and disabling condition. This three-year project (2016-2018), which ended in 2019 with the analysis of the database, led to a significant improvement of the quality of the nursing care, with a 46% reduction in the incidence of relevant skin wounds during this three-year period and implementation of the knowledge of the trained staff. Nurses also optimized the use of advanced dressing devices. Finally, patients' satisfaction was measured with a questionnaire. During the last survey a high participation was achieved (98%) with a 95% satisfaction regarding the care provided.