[Repeated use of hemodialysis equipment in the same patient]

The authors submit the development of research on multiple use of dialyzers and the present state of the capillary dialysers reuse procedure. At present automated reuse machines are used that utilise ++de-ionized rinsing water or reverse ultrafiltration with or without 0.5% solution of sodium hypochlorite, or 3% solution of hydrogen peroxide. Generally, the sterilisation employs 1-2% formaldehyde and Renalin (stabilised solution of peracetic and acetic acids and hydrogen peroxide); more seldom--5% solution of acetic acid and glutaraldehyde. The pre-rinsing procedure of dialysers could also be performed with these solutions, except formaldehyde. The authors present advantages and disadvantages of every rinsing and sterilising solutions, which are used at present. The protein coat on the dialyzer is removed effectively only with sodium hypochlorite. On the other hand, formaldehyde and Renalin are the most effective sterilising solutions. However, formaldehyde could provide the development of anti-N-like antibodies, and allergic-toxic reactions in some patients. Another problem is a negative effect of formaldehyde on the staff. Renalin's drawbacks are its photosensitivity, a corrosive character and high cost. Multiple use of reprocessed dialyzers in the same patient decreases the cost of haemodialysis by even 70%, not effecting the survival rate. Also it is of considerable medical advantage, i.e. decreases the rate of first use syndrome and improves biocompatibility at subsequent uses of the dialyzers. The decrease of elimination effectiveness is, generally, scarcely noticed, statistically irrelevant and of no essential clinical significance.