Effect of Dialyzer Reuse on Dialyzer Performance

Abstract

Background: Dialyzer reuse has been practiced for many years and since its beginning questions have been raised about safety of the practice and also its effect on dialyzer clearance of small solutes. The aim of this study was to determine the effect of reusing dialyzer on clearance of small solutes and adequacy of dialysis.
Materials and Methods: The in-vivo clearance of dialyzer that were manually reprocessed in 33 end stage renal disease patients were tested for clearance of urea and creatinine by collecting simultaneous arterial and venous blood samples one hour into dialysis at blood flow rate (QB) of 200ml/ minute and dialysate flow rate (QD) of 500ml/minute at negative pressure of 0mmHg. Urea reduction ration (URR) was used as adequacy of dialysis session. Seventeen patients used the nephorsytem cuprophand dialyzer while 16 used the fresenius F5 polysulfone dialyzers.
Results: Dialyzers were reused for four times. The clearance of urea and creatinine decreased significantly at the 4th use for the cuprophand nephrosystem dialyzers (139.5ml/minute at 1st use to 132.9+6.9ml/min at 4th use p<0.05) creatinine clearance dropped from 111.5ml/min to 107.6ml/min at 4th use p<0.0.5. the urea clearance for fresenius F5 dialyzers dropped significantly after 3rd use from 149.9+3.9ml/min to 144.5+3.8ml/min p<0.05. the mean URR declined with reuse for both F5 polysulfone dialyzer and NP08E dialyzers but this was not statisticant; for the nephrosystem cuprophan dialyzer URR dropped from 52.4+15.4 at 1st use to 46.6+11.6 at 4th use P>0.05 and for Fresenius F5 dialyzers from 52.4+7.8 at 1st use vs 48.5+5.5 at 4th use p>0.5.
Conclusion: manually reprocessed dialyzers can be used up to times without significantly affecting the solute clearance.

Keywords: dialyzer reuse, urea clearance, dialysis adequacy

Nigerian Medical Journal Vol. 48 (2) 2007: pp. 42-45