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REUSE OF DIALYZERS CAN CAUSE FEVER.

Reuse of disposable hemodialyzers has become more common in the U.S. as its apparent safety and economic benefits have been recognized. Alter and colleagues report that a Centers for Disease Control survey of 1350 chronic hemodialysis centers found that 63 percent of them reuse hemodialyzers. Reusing dialyzers more than 20 times and using manual reprocessing systems were associated with pyrogenic reactions. The authors also found an association between RenNew-D (a chemical germicide that has been removed from the market) and bacteremia.

In a related study by Gordon and colleagues, detailed review of 18 pyrogenic reactions at one center showed that these episodes were associated with reused dialyzers, and that water used to rinse the dialyzers contained high concentrations of endotoxins. When dialyzer reuse was discontinued, pyrogenic reactions fell to baseline levels.

These data indicate that while dialyzer reuse has obvious economic benefits, it also carries increased health risks unless appropriate precautions are taken.

— THL

Published in Journal Watch General Medicine October 18, 1988

Citation(s):

Gordon S M; Tipple M; Bland L A; Jarvis W R. Pyrogenic reactions associated with the reuse of disposable hollow-fiber hemodialyzers. JAMA 1988 Oct 14 260 2077-2081.

• Medline abstract (Free)

Alter M J; Favero M S; Miller J K; Coleman P J; Bland L A. Reuse of hemodialyzers: results of nationwide surveillance for adverse effects. JAMA 1988 Oct 14 260 2073-2076.

• Medline abstract (Free)