title: Effect of dialyzer reprocessing with Renalin on serum beta-2-microglobulin and complement activation in hemodialysis patients.
abstract: The peracetic acid-based sterilant Renalin is increasingly being used for reprocessing hemodialyzers. In order to evaluate the effects of reprocessing on beta 2-microglobulin (beta 2M) kinetics and complement activation in chronic hemodialysis patients, we compared 4 dialyzer membranes on 1st, 2nd and 4th use of the membrane. Dialysis with new cuprammonium rayon dialyzers (0.8 m2) for 4 h resulted in a nonsignificant increase in serum beta 2M concentrations of 10.7% (corrected for changes in extracellular volume) and significant generation of the complement component C3a des Arg. On reuse, minimal changes in serum beta 2M levels were noted and complement activation was absent. Dialysis with new cellulose acetate (CA, 1.5 m2), polyacrylonitrile (AN69 HF, 1.6 m2) or polymethylmethacrylate (PMMA, 1.6 m2) membranes resulted in significant decreases in serum beta 2M levels (19.5, 31.7 and 50.8%, respectively). Reprocessing had negligible effects on the removal of beta 2M by CA and AN69, but by the 4th use halved the effectiveness of PMMA. Reprocessing reduced the significant generation of C3a des Arg observed with new CA and PMMA membranes. We conclude that, except for PMMA, Renalin reprocessing has minor effects on the ability of the membranes to remove beta 2M and improves the biocompatibility of all membranes studied.
authors.affiliation: Department of Pathology, Royal Brisbane Hospital, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Westhuyzen
authors.forename: K
authors.initials: K
authors.lastname: Foreman
authors.forename: D
authors.initials: D
authors.lastname: Battistutta
authors.forename: D
authors.initials: D
authors.lastname: Saltissi
authors.forename: S J
authors.initials: SJ
authors.lastname: Fleming
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000368:Aged; D002482:Cellulose / Q000031:analogs & derivatives*; D003167:Complement Activation; D015926:Complement C3a / Q000031:analogs & derivatives*; D004202:Disinfectants; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008875:Middle Aged; D010463:Peracetic Acid; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D001613:beta 2-Microglobulin / Q000032:analysis*
chemical_list: D004202:Disinfectants; D004338:Drug Combinations; D008567:Membranes, Artificial; C117603:Renalin; D001613:beta 2-Microglobulin; C044541:complement C3a, des-Arg-(77)-; D015926:Complement C3a; D002482:Cellulose; C009865:cuprammonium cellulose; D006861:Hydrogen Peroxide; D010463:Peracetic Acid; D019342:Acetic Acid