Section 4: Chronic renal failure.

The treatment of chronic renal failure by extrarenal purification is carried out in the following four ways: 1° Haemodialysis in a centre ; 2° Haemodialysis in a medical dialysis unit; 3° Haemodialysis in a simple or assisted self-dialysis unit; 4° Home dialysis by haemodialysis or peritoneal dialysis.

Authorisation to implement or extend the healthcare activities referred to in Article L. 6122-1 may only be granted to health establishments treating chronic renal failure by means of extrarenal purification, which have at least the following three methods: haemodialysis in a centre, haemodialysis in a self-care unit and home dialysis. However, by way of derogation, authorisation to carry out this activity may be granted to a health establishment which does…

Any establishment that is unable to provide treatment for chronic renal failure according to the four methods mentioned in article R. 6123-54 must ensure that the patient is referred to an establishment authorised to provide the method best suited to the patient.

Each of the methods mentioned in 1°, 2° and 3° of article R. 6123-54 may only be offered to patients in a seasonal unit as defined in article R. 6123-62 when the healthcare establishment is authorised to treat chronic renal failure on a permanent basis using one of these methods.

The haemodialysis centre mainly cares for patients treated by periodic haemodialysis, whose state of health requires the permanent presence of a doctor during the session. The centre is located within a health establishment that allows patients to be hospitalised full-time in medical or, if necessary, surgical beds.

The centre has resuscitation and emergency equipment, the list of which is set by order of the Minister for Health. The same centre also has a resuscitation department, a medical biology analysis laboratory and imaging equipment or, failing that, has an agreement with other establishments that do.

The centre may only admit children aged over 8, provided that it has the appropriate equipment and that the child is accommodated in a treatment room separate from that for adults or in an isolated cubicle, and that he or she remains under the care, outside the centre, of a paediatrician with expertise in nephrology.

The haemodialysis centre for children welcomes patients from birth to the age of 18; it may also provide care for young adults when their state of health requires technical management by a paediatric centre. The centre must be able to accommodate children travelling or on holiday on haemodialysis machines that can be reserved for this purpose. The centre must be located within a healthcare establishment with a paediatric department that…

A seasonal haemodialysis unit caters for adults and children aged 8 and over, when they are travelling or on holiday. It does not care for patients living nearby. The authorisation sets out the periods when the seasonal haemodialysis unit is open and its operating characteristics. If the establishment is authorised to carry out haemodialysis in a self-dialysis unit, the seasonal unit may only receive patients who are usually given home…

The medical dialysis unit receives patients who require a non-continuous medical presence during the treatment session or who cannot or do not wish to be cared for at home or in a self-care dialysis unit.