• In honor of World Kidney Day, 26 shares the daily routines in the Nephrology Department of the Dr. Ernesto Guevara General Teaching Hospital, a place where demands intertwine with the commitment of healthcare professionals.

Inside the Nephrology Department of the Dr. Ernesto Guevara Hospital, the pace never stops. Ensuring hemodialysis, which represents the greatest life guarantee for 68 residents of Las Tunas, is a challenge that in recent times has had to adapt to the country's current conditions.

Dr. Raynar Molina Vega, a First-Degree Specialist in Nephrology and head of the ward, affirms that it is a great challenge to provide services that require so many consumable resources, without which the health of patients cannot be preserved.

"Given the current circumstances, we've been forced to make changes," the doctor explains. "Of the 68 patients requiring hemodialysis, 21 are from outlying municipalities, and transporting them to their three weekly sessions has become difficult."

"Currently, these patients are hospitalized or, so to speak, staying with family or friends in the main municipality. Taxis Cuba provides a service to pick them up from these homes before each session and return them; two patients share the vehicle to optimize fuel consumption."

"We know that their conditions make it hard to be housed or hospitalized. We've talked with them a lot, and they understand, but maintaining their quality of life remains a challenge for the hospital."

BEHIND DOORS

Daily life in the Nephrology department is complex and dynamic. The team currently consists of six specialists, 11 residents, 29 nurses, and, most importantly, their patients.

The energy crisis also complicates the situation. Patients spend four hours connected to a machine that guarantees their survival. Electricity is essential.

The head of the department explains that the reality in Las Tunas includes very young patients with kidney disease and others who have been in treatment for around 25 or 26 years. "That is the result of our work: the quality of life we can offer these people and, at the same time, extend their lives."

"About Clinical Nephrology, we currently have eight patients hospitalized with nephrotic syndromes, pathologies that require long hospital stays due to the complexity of their management. Most suffer from polycystic kidney infections. But what worries me most is that, today, we have a population with nephrological health problems, with affected kidneys, and sometimes their care doesn't follow the proper flowchart through Primary Health Care, screening, and follow-up for diabetics and hypertensive patients."

"It's regrettable to say that many times when they arrive at Secondary Care, there's no solution. The only thing we can recommend is dialysis. There's an underreporting of kidney diseases; people don't know they have the disease and wait until the last minute. And then everything worsens the prognosis."

The doctor affirms that, as in the developed world, high blood pressure and diabetes mellitus are the leading causes of chronic kidney disease in the province and in Cuba.

"I urge the people of Las Tunas to go to the health centers, to our polyclinics, which are all open. Our laboratories are conducting screenings." Diabetic and hypertensive patients need regular checkups.”

"Our community outreach program is reaching all health areas in the municipalities of Las Tunas. We have a 24-hour nephrology service at the 'Guevara' hospital for emergencies and chronic patients. I reiterate, if you have any warning signs, go to a health facility. Timely diagnosis and treatment can save lives."