Over the last decade, the Italian National Health Service has been widely criticized for failing to meet the expectations of the Italian population and to reduce the weaknesses of the health care system deriving from a lack of balance between increasing costs and comparable benefits. In order to improve health care services, a new model of acute care hospitals, characterized mainly by new structures, high technology, integration and collaboration among professionals, are necessary. The traditional concept of specialized operative unit is thus overcome by a new hospital organization in which specific functions are performed in shared facility areas. In particular, the role of the nephrologists will be reorganized into different health care settings according to the level of intensity of care: high level (intensive care unit, organ transplantation), intermediate level (medical area) or low intensity care facilities (day hospital, day surgery, day service, ambulatory).