Limited-Care Hemodialysis

Choice of the Dialysis Modality: Practical Considerations

“…The classical definitions are the following: a self-care dialysis facility is a dialysis facility where the patient performs their dialysis treatment with little or no professional assistance [82]; a limited care dialysis facility is a dialysis facility where there is specialized paramedical personnel to help clinically stable patients performing their treatment in a non-hospital facility [83]; a satellite dialysis facility is a dialysis facility where maintenance hemodialysis is provided in a hospital setting to adult patients with ESKD but these patients are supposed to be stable and do not need the highly specialized treatment provided in the main renal center [84]. The original idea was to offer a setting for the care of patients fit to perform home hemodialysis, but with unsuitable homes or without a dialysis partner [85][86][87]. The further evolution, at least in some settings, such as Italy, and to a lesser extent, in France, tended to favor treatment in proximity, and the treated population shifted from young, completely autonomous patients, to elderly patients in which the discriminating issue for the choice is not the full autonomy but the "low-risk" of intradialytic complications [61,[88][89][90].…”