Abstract
Home hemodialysis was a modality of necessity in the early days of chronic renal replacement therapies. Patients had to be independent for all aspects of their care including self-cannulation of the hemodialysis needles. As the number of in-center staff provided hemodialysis centers has grown, the level of independence for hemodialysis patients has drastically decreased. Recent changes by the United States Centers for Medicare and Medicaid Services in the 'Conditions of Coverage for ESRD' encourages all US dialysis facilities to offer and allow patients to perform their own needle cannulation. This article briefly reviews the advantages and disadvantages of patient self-cannulation. Self-cannulation can be a stepping stone to patient independence including home hemodialysis modality.