title: Rinsing time and disinfectant release of reused dialyzers: comparison of formaldehyde, hypochlorite, warexin, and renalin.
abstract: The influence of disinfecting agent (DA) type on the rinsing time of reused dialyzers and DA rebound release after rinsing is unknown. We compared 10 groups of five dialyzers each: cellulose acetate capillaries and AN69 plates disinfected with formaldehyde (F), polysulfone and cuprophane capillaries disinfected with 3.5% Renalin (R; Renal Systems, Minneapolis, MN), polysulfone capillaries and AN69 plates disinfected with 0.5% R, and AN69 capillaries and plates disinfected with Hypochlorite (H; Solvay, Brussels, Belgium) or Warexin (W; Guardian Chemical, Division of United Guardian Inc, Hauppage, NY), respectively. Formaldehyde, R, H, and W were detected by standard tests. The rinsing time required to reach undetectable levels of DA is shortest for H and W, intermediate for R 0.5% and 3.5%, and longest for F (F v R, H, and W; R v H and W; and H v W: P < 0.001). The rebound release 30 minutes after completion of rinsing is the highest for F (average 6 ppm), intermediate for R 0.5% and 3.5% (mean 1.4 ppm, P < 0.002 compared with F and mean 2.95 ppm, P < 0.05 compared with F, respectively), and low (< or = 1 ppm) for W and H (P < 0.001 compared with F and P < 0.01 compared with R 3.5% and 0.5%). We conclude that the dialyzer rinsing time needed to obtain undetectable levels of DA depends on the DA type. In addition, we demonstrate that like F, R is released from reused dialyzers after "adequate rinsing." The potential clinical consequences of this phenomenon require further investigation.
authors.affiliation: University of Louvain Medical School, Renal Unit, Cliniques Universitaires St-Luc, Brussels, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Stragier
authors.forename: D
authors.initials: D
authors.lastname: Wenderickx
authors.forename: M
authors.initials: M
authors.lastname: Jadoul
mesh_terms: D019342:Acetic Acid; D001557:Benzenesulfonates; D004202:Disinfectants; D004203:Disinfection / Q000379:methods*; D004338:Drug Combinations; D017743:Equipment Reuse; D005557:Formaldehyde; D006861:Hydrogen Peroxide; D006997:Hypochlorous Acid; D010463:Peracetic Acid; D006435:Renal Dialysis / Q000295:instrumentation*; D013501:Surface-Active Agents; D013997:Time Factors
chemical_list: D001557:Benzenesulfonates; D004202:Disinfectants; D004338:Drug Combinations; C117603:Renalin; D013501:Surface-Active Agents; D005557:Formaldehyde; C018120:oxychlorosene; D006997:Hypochlorous Acid; D006861:Hydrogen Peroxide; D010463:Peracetic Acid; D019342:Acetic Acid