Beta(2)-microglobulin clearance decreases with Renalin reuse.

Area of Science:

• Nephrology
• Biomedical Engineering

Background:

• Dialyzer reuse is a common practice to reduce costs in hemodialysis.
• Previous studies, like the HEMO study, suggested potential degradation of dialyzer performance with reuse.

Purpose of the Study:

• To evaluate the impact of polysulfone dialyzer reuse with Renalin on beta(2)-microglobulin clearance in high-flux hemodialysis.
• To compare beta(2)-microglobulin clearance before and after discontinuing dialyzer reuse.

Main Methods:

• Retrospective analysis of 31 patients undergoing online hemodiafiltration (HDFol) with F-80 polysulfone dialyzers.
• Monitoring of predialysis beta(2)-microglobulin levels and dialyzer clearances over several years, including periods with and without dialyzer reuse.
• Reuse was performed using a Renatron machine with Renalin, limited to 10 reuses per dialyzer.

Main Results:

• Beta(2)-microglobulin clearance decreased progressively during the period of dialyzer reuse.
• After discontinuing reuse in January 2000, predialysis beta(2)-microglobulin levels significantly decreased, and beta(2)-microglobulin clearance approximately doubled.
• These findings suggest that Renalin reuse degrades polysulfone dialyzer high-flux capacity.

Conclusions:

• The reuse of polysulfone dialyzers with Renalin negatively impacts beta(2)-microglobulin clearance in high-flux hemodialysis.
• Discontinuation of Renalin reuse led to improved beta(2)-microglobulin clearance.
• Reuse of polysulfone dialyzers with Renalin should be abandoned to preserve the benefits of high-flux hemodialysis, including potential reduction of dialysis-related amyloidosis.