Safety and efficacy of dialyzer reuse by manual reprocessing: an observational study

Abstract

Background: Haemodialysis is the main form of RRT in the patients of CKD. Haemodialysis is a costly procedure and is not afforded by many. Reuse of components of Haemodialysis circuit helps in reducing cost but may be associated with decreased efficacy and side effects.Methods: Prospective observational study. Manual reprocessing of dialyzer was done with either formaldehyde or peracetic acid. Single brand (Fresenius) dialyzer were used across all patients. Dialysis efficacy was calculated by URR and side effect and toxicity monitored in a predefined proforma.Results: A total 50 patients were studied (39 male and 11 female) with age ranging from 31-60 years. The mean urea reduction ratio after four dialysis session with the same dialyzer was 62.93% which is below KDOQI recommendation. The findings in our study suggest that URR was adequate upto three session of haemodialysis by reprocessed dialyzer but not beyond that. The choice of chemical for reprocessing did not affect the efficacy. As compared to F6 dialyze F8 dialyzer had better initial URR and this was maintained upto fourth reuse. Serum albumin levels correlated with the fall in efficacy of dialyzers. There were no significant complications of reuse of dialyzers across both methods of reprocessing and there was no dialyzer first use syndrome.Conclusions: ESRD affects a younger age group in our country. Use of large membrane area results in better efficacy. Dialyzer reuse with manual reprocessing is safe and also effective upto third and fourth use. Dialyzer reuse is associated with economic benefits.