Subsection 4: Chronic renal failure

Simple self-care dialysis, as defined in article R. 6123-65, only involves trained patients who are able to carry out all the procedures necessary for their treatment themselves, in particular weighing, monitoring blood pressure, preparing the dialysis machine, connecting and disconnecting the extracorporeal circulation circuit and starting the automatic disinfection of the machine at the end of the session.

Back-up is provided in a haemodialysis centre or in a medicalised dialysis unit under the conditions set out in article D. 6124-67. When it is provided for by agreement, this agreement mentions the number of dialysis patients being treated; this number of patients is to be taken into account by the health establishments carrying out the transfer, in order to calculate the number of transfer stations required.

All self-dialysis units operate with the assistance of nephrologists who are qualified or competent in nephrology. The team of nephrologists may be shared with that of a haemodialysis centre or a medical dialysis unit. This team is on call twenty-four hours a day to respond to any medical emergencies for patients undergoing dialysis in the unit. This on-call service may also be provided under the conditions set out in article…

The so-called simple self-dialysis unit has at least one nurse trained in haemodialysis for every eight patients treated, without prejudice to other paramedical staff. The assisted self-dialysis unit has at least one nurse trained in haemodialysis for every six patients treated, without prejudice to other paramedical staff. All units have a nurse on duty during the session, even when only two patients are being treated simultaneously.

The premises in which the simple self-dialysis unit or the assisted self-dialysis unit is installed may be shared by these units, a medical dialysis unit or a haemodialysis centre. In this case, the patients treated simultaneously are dialysed in separate rooms, depending on whether simple self-dialysis, assisted self-dialysis or medicalised dialysis is involved. However, it is possible to treat a group of haemodialysis patients successively in the same room in…

In the simple self-dialysis unit, each patient is allocated a dialysis machine, without sharing, to ensure a wide range of treatment times. Patients themselves monitor the dialysis session and clean and disinfect the machine themselves. In the assisted self-dialysis unit, a haemodialysis station can only be used by a maximum of two patients per day, to allow them to have longer sessions if they so wish or if medically indicated….