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You are doing a holiday job at a nearby dialysis centre. Looking at the tedious procedures that the patients go through everyday has heightened your compassion for them and increased your alertness to health conditions.

One day, you begin to notice that more and more patients are coming back to the dialysis centre for help as they are developing the nephrotic syndrome (doctor's diagnosis). Looking at the patient records, you discover that these are patients who have just come for dialysis a few days ago, or even everyday! "This is unusual!" you think, and begin to investigate further.

The senior nurse who is usually in charge of the dialysis machines is on medical leave so you speak to the new assistant, Lena. Lena, flustered and fearful, quickly explains to you that she has tried to make sure everything was done the same way the senior nurse taught her to. You take a look around the machines, her office and the storeroom. Indeed everything seems fine, except for the messy organization of the bags of the dialysis fluids.

Investigate what has happened at the dialysis centre and explain why the patients developed the nephrotic syndrome.