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Negli ultimi anni si assiste a un rinnovato interesse per l'emodialisi domiciliare nel trattamento dell'insufficienza renale cronica, anche grazie alle recenti innovazioni tecnologiche che consentono di effettuare tale trattamento più agevolmente che in passato. Il revival di questa metodica suscita un interessante dibattito nella comunità scientifica e tale dibattito ultimamente, in Italia, ha visto l'espressione di alcune posizioni critiche nella piattaforma NephroMEET. In questo contributo, si sottolineano le principali evidenze cliniche e gli effetti psicologici e sociali di questa metodica, attraverso un approfondimento della letteratura più recente e grazie all'analisi conversazionale di un caso di successo. La prospettiva da cui si parte è quella relativa al concetto di salute, come definito dall'OMS. Si evidenzia come l'emodialisi extracorporea domiciliare presenti importanti vantaggi sia clinici che psicosociali, configurandosi come una valida alternativa dopo il trapianto e la dialisi peritoneale.

Recently we observed a renewed interest in home hemodialysis for the treatment of chronic renal disease thanks to the latest technological innovations, which allow to undergo this treatment more easily than in the past. The revival of this method raises an interesting debate in the scientific community; this debate has shown some critical positions in Italy through the NephroMeet platform. In this paper we highlight the main clinical evidences and the psychological and social effects of home hemodialysis, through a revision of the most recent literature and the conversational analysis of a successful case. Our perspective starts from the concept of health as defined by the WHO. We show how home extracorporeal hemodialysis presents important advantages, both clinical and psychosocial, and why it should be considered as a valid alternative after transplantation and peritoneal dialysis.

Benzodiazepines, consisting of a benzene ring joined to a diazepine ring and a phenyl radical, are a class of drugs mainly used for the treatment of anxiety symptoms. They increase the transmission of gamma-aminobutyric acid (a kind of endogenous anxiolytic) and, therefore, they have an anxiolytic, sleep-inducing or sedative, myorelaxing, anticonvulsive, and anesthetic effect. They have minimal interactions with other drugs, but too often they are used as a long-term therapy instead of being used only when they are really necessary. The Territorial Pharmacist can play an important role in solving this problem. In patients with renal disease it is important to consider that the pharmacokinetics of these drugs, and therefore the absorption, degradation, and excretion of both their active principles and their metabolites are altered factors in case of kidney failure. Patients with renal disease make use of benzodiazepines more than the general population; however in these patients it is necessary to reduce the dose of about one third of the maximum dose allowed in patients with normal renal function. Additional research is also needed to investigate the main reasons of benzodiazepines use by patients with kidney disease.