Extended reuse of @entity2264 hemodialysis membranes using XXXX and heat.

@entity1 @entity1133 @entity2264 @entity1792 @entity2262 @entity1011
The concomitant use of @entity1792 and prolonged exposure to heat (CAH) is an increasingly common alternative to purely chemical means of reusing dialyzers. However, there are no data on the effects of reprocessing dialyzers with CAH beyond 15 uses. Increasing the number of reuses with CAH cannot be systematically undertaken unless its safety is documented. We hypothesized that discarding @entity2264 dialyzers after the 25th rather than the 15th use would result in increased clearance of @entity2262 ( @entity2262 ) without clinically significant changes in small solute clearance or albumin loss. We studied 15 Fresenius F80B @entity2264 dialyzers in five chronic hemodialysis @entity1 . Dialyzers were reprocessed using 1.5% @entity1792 solution heated to 95 degrees C. Representative fractional collection and 10 minute timed collections of dialysate were performed at baseline and during uses 5, 10, 15, 20, and 25 for each dialyzer. Dialysate-side @entity1133 , @entity1011 , and @entity2262 clearances were calculated, and total albumin was measured in dialysate. We used a mixed model to adjust for repeated measures (both within a given dialyzer and for the multiple dialyzers per @entity1 ). Of the 15 dialyzers studied, 3 (20%) failed before the 25th use. There was no significant change in @entity1133 or @entity1011 clearance with additional reuse (overall p values 0.20 and 0.60, respectively). A sustained increase in @entity2262 clearance was observed after the fifth treatment compared with the first use (p < 0.001). Fractional collection showed that dialysate albumin loss increased significantly with additional reuses (p < 0.001) but did not increase significantly above baseline until treatment 25. Reprocessing of @entity2264 dialyzers with CAH 25 times significantly increased albumin loss and @entity2262 clearance but did not appear to affect @entity1133 or @entity1011 clearance. Increasing the maximum number of uses to 20 may permit cost savings compared with current practice without additional risk.
