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The dialysis prescription: reuse
1Division of Nephrology, Stanford University, Calif 94305-5114, USA.
American Journal of Nephrology
|January 1, 1996
Summary
Dialyzer reprocessing is appropriate when guidelines are followed, offering cost savings and reduced patient symptoms. Risks of infection and exposure to sterilants must be managed carefully.
Area of Science:
- Nephrology
- Medical Device Reprocessing
- Infection Control
Background:
- Hemodialyzer reuse is a widespread practice facing ongoing criticism in various forums.
- Key sterilant/germicides used in the US for hemodialyzer reprocessing include peracetic acid, formaldehyde, and glutaraldehyde.
- Heat sterilization is a less common reprocessing method.
Purpose of the Study:
- To review the advantages and disadvantages of hemodialyzer reprocessing.
- To discuss the implications of reprocessing on patient outcomes, including hospitalization and mortality.
- To provide guidance on the appropriate use of dialyzer reuse.
Main Methods:
- Review of existing literature and reports on hemodialyzer reprocessing.
- Discussion of sterilant/germicides used and their prevalence.
- Analysis of reported benefits and risks associated with dialyzer reuse.
Main Results:
- Reprocessing offers benefits such as reduced cost, decreased first use syndrome, and fewer intradialytic symptoms, potentially due to enhanced biocompatibility.
- Data on hospitalization rates is limited; mortality rate reports are discussed.
- Disadvantages include risks of infection and patient/staff exposure to sterilants.
Conclusions:
- Hemodialyzer reuse remains appropriate if manufacturers' guidelines and AAMI Recommended Practices are adhered to.
- Ensuring the delivery of the prescribed dialysis prescription is crucial for safe reuse.
- Careful management of risks associated with reprocessing is essential.