Juan Manuel Buades Fuster, Head of the Nephrology Service of the Son Llàtzer Hospital, has been awarded in the Siglo XXI Medicine Awards 2020 in the Nephrology category. This nephrologist specializing in kidney diseases, arterial hypertension and the prevention of kidney stones, dialysis and clinical nephrology, has received this award for his clinical work with his patients, as well as for its management and investigations.
In an interview with Medical Writing, the head of Nephrology at Son Llàtzer has explained how it has been to receive this recognition, and about the way in which the Covid-19 pandemic has affected the Chronic Kidney Disease strategy in the Balearic Islands.
Further, Buades points out the main advances that the nephrology sector will experience in the coming years. A series of technological innovations that are aimed at giving greater autonomy and quality of life to patients with kidney diseases.
How has it been for you to receive the 2020 XXI Century Medicine Award?
Very exciting, especially because from what I have been able to understand, those who have assessed whether I deserve the award or not have been the patients, so for me this has the maximum value.
Despite the fact that I am the head of the department and I have management tasks and I carry out other series of questions related to medical informatics, my most precious work and my true vocation is to act as a doctor treating patients, so that recognition fills me with satisfaction.
How has Covid-19 affected the Chronic Kidney Disease Strategy in the Balearic Islands, which you coordinate?
Some of the projects we had underway have stopped. At this time we were evaluating renewing the relationship between nephrology and Primary Care. Every five years we meet and define criteria for referral and the management of patients with chronic kidney disease in primary care. We had to interrupt it, I hope we will resume it soon.
“At this time we were evaluating renewing the relationship between Nephrology and Primary Care”
In addition, the home hemodialysis contest that we had planned for this year has delayed us. We have also had changes in the consultations, we have had to incorporate the telematic visit, which is basically by telephone, and that has its consequences, some good and others not so good.
With what has been learned by force these months, how do you think the approach to the kidney patient will evolve in the medium and long-term future?
At the Balearic level, another project that is very important for us and that has also been affected is the Nefrored project, which is the nephrological network of specific computer programs to treat kidney patients.At this moment we have already incorporated 2 hospitals, but there are still 4, including the referral hospital.
But when this program becomes a reality, the management capacity of the renal population that we are going to have will be very powerful, because we will have a lot of information available and in a structured way, which will allow us to apply artificial intelligence for decision-making. This will mean a fundamental change in the management of kidney patients in the Balearic Islands, because we will go from a vision in which each one does their job and sends information to the other in the form of reports, emails, telephone information … To share the information in a very structured way.
What technological innovations do you expect for the treatment of kidney patients?
In the end what we are looking for is to give more freedom and more autonomy to the kidney patient and obviously that the one that gives it best is kidney transplantation. But it is also a reality that not all patients can be transplanted or not all can do it at the time that would be best for them. So for that we need dialysis.
What the new advances will probably try is to give more autonomy and more freedom to the patient undergoing dialysis. At this time, simpler hemodialysis monitors have already been developed so that patients not only have the possibility to do dialysis at home using peritoneal dialysis, which has been used for some time, but also to do hemodialysis at home.
And the next steps will be that each time this type of device is smaller, more efficient, with new materials and new technology, to the point where perhaps in time they will be implantable. The innovation could be aimed at giving kidney patients freedom of movement. Not having to go to a hospital is enough if you have dialysis at home, but not having to be linked to a machine even at home is also very important. Although the possibility of generating organs through cells with tissue engineering is being advanced, this will probably take a while. However, little progress is being made in miniaturizing monitors or dialysis machines, to the point that they could become portable or implantable, favoring greater freedom for people with chronic kidney disease.
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