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Dialyzer reuse

Ashish Upadhyay, Bertrand L Jaber
The practice of reprocessing dialyzers for reuse, once predominant in the United States, has been steadily declining over the last 20 years. The professed roles of reuse in improving dialyzer membrane biocompatibility and lowering the risk of first-use syndrome have lost relevance with the advent of biocompatible dialyzer membranes and favorable sterilization techniques. The potential for cost-savings from reuse is also called into question by the easy availability of comparatively cheaper dialyzers and rising regulatory demands and operational cost of reprocessing systems...
January 8, 2017: Seminars in Dialysis
Chris Edens, Jacklyn Wong, Meghan Lyman, Kyle Rizzo, Duc Nguyen, Michela Blain, Sam Horwich-Scholefield, Heather Moulton-Meissner, Erin Epson, Jon Rosenberg, Priti R Patel
BACKGROUND: Clusters of bloodstream infections caused by Burkholderia cepacia and Stenotrophomonas maltophilia are uncommon, but have been previously identified in hemodialysis centers that reprocessed dialyzers for reuse on patients. We investigated an outbreak of bloodstream infections caused by B cepacia and S maltophilia among hemodialysis patients in clinics of a dialysis organization. STUDY DESIGN: Outbreak investigation, including matched case-control study...
December 7, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Michael V Rocco
BACKGROUND: Chronic hemodialysis (HD) in the 1960s encompassed a wide variety of prescriptions from twice weekly to five times per week HD. Over time, HD prescriptions in the West became standardized at three times per week, 2.5-4 h per session, with occasional additional treatments for volume overload. SUMMARY: When clinical trials of dialysis dose failed to show significant benefit of extending time compared with the traditional dialysis prescription, interest in more frequent HD was renewed...
December 2015: Kidney Diseases
Narayan Prasad, Vivekanand Jha
BACKGROUND: Asia is the largest, most populous and most heterogeneous continent in the world. The number of patients with end-stage renal disease is growing rapidly in Asia. SUMMARY: A fully informed report on the status of dialysis therapies including hemodialysis (HD) is limited by the lack of systematic registries. Available data suggest remarkable heterogeneities, with some countries like Taiwan, Japan and Korea exhibiting well-established HD systems, high prevalence and universal access to all patients, while low- and low-middle income countries are unable to provide HD to eligible patients because of high cost and poor healthcare systems...
December 2015: Kidney Diseases
Ruqaya Qureshi, Murtaza F Dhrolia, Kiran Nasir, Salman Imtiaz, Aasim Ahmad
Reusing dialyzers is almost universal in developing countries to reduce the cost of hemodialysis (HD). Economic benefits of dialyzer reuse, when estimated only on the basis of the dialyzer and its consumables are very significant and attractive. In this study, we compared the cost of mechanical reuse of dialyzer considering all of the direct costs (medications, dialyzer, and its consumables, disinfection fluid, and hospitalization if any) in HD treatment, which if significantly different between single use and reuse, can nullify the obvious cost benefits...
July 2016: Saudi Journal of Kidney Diseases and Transplantation
Cuong Minh Duong, Mary-Louise McLaws
BACKGROUND: Hepatitis C virus (HCV) is a risk for all hemodialysis patients. Over a 2-month period in 2013, there were 11 HCV seroconversions at a satellite hemodialysis unit in Vietnam. We report the epidemiologic investigation of the transmission mode in the absence of unavailable phylogenetic analysis. METHODS: The outbreak occurred during a 2-year dynamic cohort study. All patients were tested every 2 months, and staff was tested annually for hepatitis B virus surface antigen and HCV core antigen...
May 1, 2016: American Journal of Infection Control
Jolanta Malyszko, Andrzej Milkowski, Ewa Benedyk-Lorens, Teresa Dryl-Rydzynska
No abstract text is available yet for this article.
February 1, 2016: Archives of Medical Science: AMS
Alexandra do Rosário Toniolo, Maíra Marques Ribeiro, Marina Ishii, Cely Barreto da Silva, Lycia Mara Jenné Mimica, Kazuko Uchikawa Graziano
A cross-sectional study was conducted to evaluate the effectiveness of manual and automated dialyzer reprocessing. Dialyzers were filled with fluid thioglycollate medium from blood and dialysate chambers after being reprocessed and chemically sterilized with 0.2% peracetic acid. They were incubated for 14 days at 35°C ± 2°C, and microbiologic analysis was performed. Microorganisms were identified in 3 of the 11 samples (27.3%) from the blood chambers: Sphingomonas paucimobilis (2/3) and Penicillium spp (1/3) and in 11 of the 11 samples (100%) from the dialysate chambers: S paucimobilis (7/11), Stenotrophomonas maltophilia (4/11), Pseudomonas aeruginosa (3/11), Candida spp (1/11), and Acinetobacter baumannii (1/11)...
June 1, 2016: American Journal of Infection Control
Cuong Minh Duong, Dariusz Piotr Olszyna, Phong Duy Nguyen, Mary-Louise McLaws
BACKGROUND: Hemodialysis is an increasingly common treatment in Vietnam as the diagnosis of end stage renal disease continues to rise. To provide appropriate hemodialysis treatment for end-stage renal disease patients, we conducted a 1-year cross-sectional study to measure the prevalence of bloodborne infection and factors associated with non-compliant behaviors in hemodialysis patients. METHODS: One hundred forty-two patients were tested for hepatitis B virus (HBV) surface antigen and hepatitis C virus (HCV) core antigen...
2015: BMC Nephrology
Christos Argyropoulos, Maria-Eleni Roumelioti, Abdus Sattar, John A Kellum, Lisa Weissfeld, Mark L Unruh
BACKGROUND: The bulk of randomized trial evidence for the expanding use of High Flux (HF) hemodialysis worldwide comes from two randomized controlled trials, one of which (HEMODIALYSIS, HEMO) allowed, while the other (Membrane Outcomes Permeability, MPO) excluded, the reuse of membranes. It is not known whether dialyzer reuse has a differential impact on outcomes with HF vs low flyx (LF) dialyzers. METHODS: Proportional Hazards Models and Joint Models for longitudinal measures and survival outcomes were used in HEMO to analyze the relationship between β2-microglobulin (β2M) concentration, flux, and reuse...
2015: PloS One
Garima Mittal, Pratima Gupta, Bhaskar Thakuria, Gulshan K Mukhiya, Manish Mittal
BACKGROUND AND AIM: Viral hepatitis and human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality in hemodialysis (HD) patients. The present study was performed to assess the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV) and HIV infections in hemodialysis patients of a tertiary care hospital in Uttarakhand. METHODS: All patients undergoing maintenance HD at our center were screened for hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), antibody to HDV (anti-HDV) and HIV antibody by ELISA...
March 2013: Journal of Clinical and Experimental Hepatology
Murtaza F Dhrolia, Kiran Nasir, Salman Imtiaz, Aasim Ahmad
In spite of controversies, dialyzer reuse has remained an integral part of hemodialysis because of lower cost, good overall safety record, and improved membrane biocompatibility. Reuse declined in developed countries from the beginning of this century because of mass production of hemodialyzers at favourable price with better biocompatible membrane. Abandoning dialyzer reuse became challenging in South Asian region, where more than 40% of the population live below the International Poverty Line of $1.25 per day, less than 10% of end stage renal disease patients receive renal replacement therapy, and upto 70% of those starting dialysis stop treatment due to cost within the first 3 months...
August 2014: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Jenny I Shen, Maria E Montez-Rath, Aya A Mitani, Kevin F Erickson, Wolfgang C Winkelmayer
PURPOSE: Heparin is commonly used to anticoagulate the hemodialysis (HD) circuit. Despite the bleeding risk, no American standards exist for its administration. We identified correlates and quantified sources of variance in heparin dosing for HD. METHODS: We performed a cross-sectional study of patients aged 67 years or older who underwent HD with heparin on one of two randomly chosen days in 2008 at a national chain of dialysis facilities. Using a mixed effects model with random intercept for facility and fixed patient and facility characteristics, we examined heparin dosing at patient and facility levels...
May 2014: Pharmacoepidemiology and Drug Safety
Natalia C V Melo, Rosa M A Moyses, Rosilene M Elias, Manuel C M Castro
There are no studies evaluating the impact of dialyzer reprocessing on solute removal in short-daily online hemodiafiltration (OL-HDF). Our aim was to evaluate the impact of dialyzer reuse on solute removal in daily OL-HDF and compare with that in high-flux short-daily hemodialysis (SDH). Fourteen patients undergoing a SDH program were included. Pre-dialysis and post-dialysis blood samples and effluent dialysate were collected in the 1st, 7th, and 13th dialyzer uses in SDH sessions and in daily OL-HDF sessions...
April 2014: Hemodialysis International
Kelsey Oyong, Patricia Marquez, Dawn Terashita, L'Tanya English, Hector Rivas, Eszter Deak, Laurene Mascola
This report details an outbreak investigation conducted by the Los Angeles County Department of Public Health of 3 cases of bacterial infection among patients receiving hemodialysis who were treated at the same dialysis center in 2011. Improper disinfection of reusable dialyzers was hypothesized as the source of transmission.
January 2014: Infection Control and Hospital Epidemiology
Amanda D Rocha, Vanessa C Padua, Esther Oliveira, Márcia M Guimaraes, Jocemir R Lugon, Jorge P Strogoff de Matos
Systemic anticoagulation with unfractionated heparin is commonly used in maintenance hemodialysis (HD), but it increases the risk of bleeding complications. We investigated whether the use of citrate-enriched bicarbonate based dialysate (CD) would reduce systemic anticoagulation without compromising the efficacy of reprocessed dialyzers. This is a crossover study in which half of a total of 30 patients initially underwent HD with acetate-enriched bicarbonate based dialysate and a standard heparin dose of ∼ 100 IU/kg (Treatment A), whereas the remaining patients were treated with CD and a 30% reduced heparin dose (Treatment B)...
April 2014: Hemodialysis International
Mohamed H Yassin, Vineet Gupta
Hemodialysis (HD) patients are particularly vulnerable to Hepatitis B virus (HBV) and have less sustained and lower antibody response to HBV vaccination. Among blood-borne pathogens, HBV can stay alive on environmental surfaces for over a week. The incidence of HBV was extremely high among HD patients. HBV vaccination, screening of blood products and infection control measures lead to significant decrease of HBV among HD patients. The infection control measures include; Medication safety and injection practices, environmental cleaning and disinfection, reuse of dialyzers for same patients, hand hygiene, isolation and barrier precautions, HBV vaccination and routine serology checking, assuring HBV immune status for HD unit staff, transmission based precautions and outbreak management...
June 2013: Infectious Disorders Drug Targets
Michio Mineshima
No abstract text is available yet for this article.
2013: Nihon Jinzo Gakkai Shi
Isolda Prado de Negreiros Nogueira Maduro, Carla Barbosa Nonino, Luiz Maçao Sakamoto, Maurício Gomes Meirelles, José Abrão Cardeal Da Costa, Julio Sergio Marchini
RATIONAL: Among the alternatives to reverse chronic hemodialysis protein-energy malnutrition is the enhancement of intradialytic oral nutritional therapy. Although foods of animal origin are a source of nutrients and represent a feasible diet, there is uncertainty about their health consequences. OBJECTIVES: We assessed the relationship of intradialytic high-protein red meat snack supplementation with patient inflammatory status and protein losses (nitrogen) during this supplementation...
July 2013: Renal Failure
P Ramakrishna, E Prabhakar Reddy, M M Suchitra, A R Bitla, P V Srinivasa Rao, V Sivakumar
Patients with chronic renal failure, especially those on long-term hemodialysis (HD), have a high incidence of premature cardiovascular disease. Oxidative stress, which occurs when there is an excessive free radical production or low antioxidant level, has recently been implicated as a causative factor in atherogenesis. Hourly changes in malondialdehyde (MDA) and antioxidant enzymes, vitamins, lipid profile and ferric reducing ability of plasma (FRAP) were studied with the first use and immediate subsequent reuse of polysulfone dialysis membrane in 27 patients on regular HD treatment...
May 2012: Indian Journal of Nephrology
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