Dear Editor,

Chronic kidney disease (CKD) is a serious public health problem with biological, mental and social implications.1-4 The characteristics of CKD patients on haemodialysis (HD) have changed in recent years. Age and comorbidity have increased, which has implications on functional aspects. Haemodialysis centres are seeing patients with a significant degree of dependence.5 The greater percentage of elderly patients makes it more difficult to modify the dialysis technique, requiring increased social care.6 For these reasons, and to improve the quality of care given to our patients, the idea of creating the role of unit healthcare coordinator was suggested in 2006. Initially, the coordinator saw 5 patients on a part time basis, although this help proved so invaluable that he was recently made full time. He is currently involved in managing tasks for a total of approximately 75 patients. Among his duties are liaison with the referral hospital, processing additional test documentation and consultations with other specialist departments. He also accompanies patients, if necessary, thus preventing the continuous loss of appointments and helps the nephrologist communicate with other specialists. Sometimes he acts as liaison with primary care and, if necessary, with social workers where there is a need for care. He also organises transfers, holidays, etc., which is very helpful for patients who are involved in complex bureaucratic procedures, thus facilitating their adaptation within the limitations of their disease.

This results in patients in our unit benefitting from improved care that goes beyond haemodialysis sessions, with a more global view of the problems they experience.

We, as nephrologists, have seen a clear improvement in organisation and care, providing the quality health care required by our patients.

We therefore encourage other haemodialysis centres to consider appointing a similar healthcare coordinator among their personnel.