A Review of Hemodialyzer Reuse

A new spectrophotometric method to detect residual amounts of peroxide after reprocessing hemodialysis filters

“…The present results suggest that the quantitative test could increase patient's safety in the reuse process. Indeed, severe hypersensitivity reactions to PA were described after reprocessing of HD filters with peroxide, which may manifest as dizziness, headache, nausea, bronchospasm and even death (8,9,17) . On the other hand, it is possible that small amounts of peroxide residue could go unnoticed in the beginning of the dialysis session, yielding no symptoms.…”

“…Major advantages of this practice include cost reduction and a decrease in the incidence of first use syndrome (6)(7)(8)(9) . Major disadvantages include exposure of the internal milieu to germicides, risk of pyrogenic reactions and infections, reduced efficiency of the dialyzers, and possibly increased oxidative stress (8)(9)(10)(11)(12)(13)(14) . In accordance with the Association for the Advancement of Medical Instrumentation (AAMI) and the Centers for Disease Control and Prevention (CDC), peracetic acid (PA) is currently the most frequently used sterilizer for reprocessing of dialyzers (15) .…”

“…Standards for reuse of dialyzers have been set by these agencies. The basic procedure for dialyzer reprocessing comprises four steps: rinsing, cleaning, performance testing, and disinfection and sterilization (8,9) Before starting a new dialysis session, the clinical staff must assure that no residue of PA is present within the HD filter and its lines. Indeed, the presence of very small amounts of PA can induce a strong host response with severe respiratory distress and hypotension (10) .…”

Effectiveness of ozonated water in the reprocessing of blood dialyzers

“…This practice requires high-fl ux dialyzers, which are more expensive and durable. The reuse of dialyzers decreases the incidence of reactions attributed to fi rst use, and allows dialysis treatment to be widely available (Cho et al, 2004;Miles and Friedman, 1997).…”