The dialysis prescription: reuse.
Despite the widespread long practice of reuse there is continued criticism of the technique both in the media, journals and more recently at specially convened meetings. In the United States there are three principal sterilant/germicides used in reprocessing hemodialyzers: peracetic acid, formaldehyde and glutaraldehyde. The use of peracetic acid now exceeds that of formaldehyde while the more recent development of heat sterilization is only practiced in a few units. The major advantages of reprocessing include reduced cost, reduced first use syndrome and intradialytic symptoms which may be a result of increased biocompatibility with reuse. There is little data with regard to hospitalization and the recent reports of mortality rates are discussed. The major disadvantages associated with reprocessing include risks of infection, chronic exposure and accidental exposure to patients and staff to the sterilant germicide. We conclude that the reuse of dialyzers continues to be appropriate provided units follow the manufacturer's guidelines, the AAMI Recommended Practices and have a method in place to ensure the prescribed dialysis prescription is delivered.
Maidment
H J
HJ
Division of Nephrology, Stanford University, Calif 94305-5114, USA.
Petersen
J
J
D001672:Biocompatible Materials; D017743:Equipment Reuse; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D055656:Prescriptions; D006435:Renal Dialysis / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation*; D012307:Risk Factors
D001672:Biocompatible Materials