Educational > Alternatives and Resources
REUSE (part b)
admin:
so
Joined: 18 Feb 2003
Posts: 1
PostPosted: Tue Feb 18, 2003 6:22 am Post subject: here you go!
The effect of dialyzer reuse on dialysis delivery <
>RA Sherman, RP Cody, ME Rogers and JC Solanchick <
>Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.<
> <
>It is well documented that the reprocessing of dialyzers may reduce their solute clearance capabilities. However, the effect of dialyzer reuse has never been assessed in an uncontrolled clinical practice setting. We addressed this issue in a prospective 436-patient, 34- center study. All patients underwent formal urea kinetic modeling monthly, usually for 3 sequential months. Dialyzers were reprocessed and reused in the usual manner for each unit. As a result, urea kinetic modeling was performed in individual patients using dialyzers with differing numbers of prior uses. For each patient, Kt/V urea for the treatment using the dialyzer with the most reuses (mean, 13. was compared with that with the treatment using the dialyzer with the fewest reuses (mean, 3. . The mean Kt/V delivered for high reuse treatments was significantly lower than that for low reuse treatments (1.05 v 1.10, P = 0.002). Prescribed Kt/V in high and low reuse treatments was identical. Individual centers appeared to differ substantially (P = 0.06) in the effect of reuse on delivered Kt/V. Of the 23 centers using formalin-based reprocessing, an average difference of > or = 0.12 (mean, 0.17) in Kt/V between high and low reuse treatments was seen in 10 centers. Dialyzer reprocessing significantly impairs dialysis delivery, an effect that may be related to the methods and procedures in individual dialysis centers. <
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REUSE
Joined: 22 Feb 2003
Posts: 5
PostPosted: Sat Feb 22, 2003 6:44 am Post subject: Reuse is bad Reply with quote
Read the FYI it contains clinical studies and not those that are industry driven for profit. <
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REUSE
Joined: 22 Feb 2003
Posts: 5
PostPosted: Fri Feb 28, 2003 1:33 pm Post subject: more information
1980's Renalin reactions<
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> www.accessdata.fda.gov/sc...ey_Count=0 <
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>Roxy<
>Unregistered User<
>(10/3/02 8:28:46 pm)<
>Reply 1980-1989 Renalin Reactions<
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> www.accessdata.fda.gov/sc...ey_Count=0 <
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>Roxy<
>Unregistered User<
>(10/3/02 8:30:06 pm)<
>Reply 1990 Renalin Reactions<
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> www.accessdata.fda.gov/sc...ey_Count=0 <
> <
>Roxy<
>Unregistered User<
>(10/3/02 8:32:56 pm)<
>Reply 1991 Renalin Reactions<
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> www.accessdata.fda.gov/sc...ey_Count=0 <
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>Roxy<
>Unregistered User<
>(10/3/02 8:35:12 pm)<
>Reply Dializer reuse article<
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> www.drlerner.com/articles/article9.html <
> <
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Hugh
Joined: 18 Dec 2003
Posts: 1
PostPosted: Thu Dec 18, 2003 9:16 pm Post subject: This could be the causitive agent Reply with quote
MSDS: Dihydrogen Monoxide<
>Dihydrogen monoxide (also known as hydric acid) is responsible for injury, death, and property damage all over the world. Visit the Dihydrogen Monoxide Research Division online at www.dhmo.org, or send email to info@dhmo.org for more information. <
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>MATERIAL SAFETY DATA SHEET FOR DIHYDROGEN MONOXIDE<
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>PRODUCT NAME: DIHYDROGEN MONOXIDE<
>FORMULA WT: 18.00<
>CAS NO.: 07732-18-5<
>NIOSH/RTECS NO.: ZC0110000<
>COMMON SYNONYMS: DIHYDROGEN OXIDE, HYDRIC ACID<
>PRODUCT CODES: 4218,4219<
> EFFECTIVE: 05/30/86 <
> REVISION #01 <
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>LABORATORY PROTECTIVE EQUIPMENT<
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>SAFETY GLASSES; LAB COAT<
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>PRECAUTIONARY LABEL STATEMENTS<
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>STORAGE: KEEP IN TIGHTLY CLOSED CONTAINER.<
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>BOILING POINT: 100 C ( 212 F) VAPOR PRESSURE(MM HG): 17.5<
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>MELTING POINT: 0 C ( 32 F) VAPOR DENSITY(AIR=1): N/A<
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>SPECIFIC GRAVITY: 1.00 EVAPORATION RATE: N/A<
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>SOLUBILITY(H2O): COMPLETE (IN ALL PROPORTIONS) % VOLATILES BY VOLUME: 100<
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>APPEARANCE & ODOR: ODORLESS, CLEAR COLORLESS LIQUID.<
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>TOXICITY: LD50 (IPR-MOUSE)(G/KG) - 190<
> LD50 (IV-MOUSE) (MG/KG) - 25<
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>DISPOSAL PROCEDURE<
> DISPOSE IN ACCORDANCE WITH ALL APPLICABLE FEDERAL, STATE, AND LOCAL<
> ENVIRONMENTAL REGULATIONS.<
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>SAF-T-DATA(TM) STORAGE COLOR CODE: ORANGE (GENERAL STORAGE)<
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>SPECIAL PRECAUTIONS<
> KEEP CONTAINER TIGHTLY CLOSED. SUITABLE FOR ANY GENERAL CHEMICAL STORAGE<
> AREA. DIHYDROGEN MONOXIDE IS CONSIDERED A NON-REGULATED PRODUCT, BUT<
> REACTS VIGOROUSLY WITH SOME MATERIALS. THESE INCLUDE SODIUM, POTASSIUM<
> AND OTHER ALKALI METALS; ELEMENTAL FLUORINE; AND STRONG DEHYDRATING AGENTS<
> SUCH AS SULFURIC ACID. IT FORMS EXPLOSIVE GASES WITH CALCIUM CARBIDE.<
> AVOID CONTACT WITH ALL MATERIALS UNTIL INVESTIGATION SHOWS SUBSTANCE IS <
> COMPATIBLE. EXPANDS SIGNIFICANTLY UPON FREEZING. DO NOT STORE IN RIGID<
> CONTAINER AND PROTECT FROM FREEZING.<
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>DOMESTIC (D.O.T.)<
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>PROPER SHIPPING NAME CHEMICALS, N.O.S. (NON-REGULATED)<
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>INTERNATIONAL (I.M.O.)<
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>PROPER SHIPPING NAME CHEMICALS, N.O.S. (NON-REGULATED)<
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Coil
Joined: 14 Jan 2003
Posts: 27
PostPosted: Sat Dec 20, 2003 3:25 am Post subject: Renalin Reply with quote
Hugh, what documentation do you have stating Renalin contains DMHO?
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little joke
Joined: 28 Mar 2004
Posts: 1
PostPosted: Sun Mar 28, 2004 6:50 am Post subject: Don't take the post from Hugh seriously
Seems Hugh was having a little fun. DHMO is H20, water.
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plugger
Joined: 11 Jan 2003
Posts: 226
PostPosted: Wed Aug 09, 2006 4:54 am Post subject: 2004 study
All analyses suggested favourable survival advantage among patients treated with single use dialysers.
The reprocessing of disposable dialysers was first proposed for economic reasons [1]. Early studies suggested that the reprocessing and reuse of dialysers manufactured using cellulosic membranes conferred medical benefits to patients, apparently rendering the membrane more biocompatible with blood?
Dialysers using synthetic membranes have largely replaced those using cellulosic membranes in recent years. More than 80% of dialysis units used cellulosic dialysers in 1990 while <25% used any dialysers with a synthetic membrane. Those statistics were reversed by 2000 such that <25% of facilities used any cellulosic dialysers while >80% used synthetic membrane dialysers [4]. The synthetic membranes are more biocompatible than their cellulosic predecessors so the reuse-associated medical benefit probably disappeared. The rationale for reusing synthetic membrane dialysers thus became purely financial.?
Reprocessing dialysers is essentially limited remanufacturing that involves the cleaning and disinfection of a medical device. The practice is subject to few controls in the USA. Manufacturers could not follow such an uncontrolled practice for first use dialysers under current regulations in the USA (United States Code of Federal Regulations, Title 21, Parts 1, 26, 110, 211, 860, 876. April 1, 2003). The exposure of membranes to different disinfection chemicals and processes may
alter those membranes in unpredictable ways [14]. Hence, the membrane used may not be functionally equivalent to the membrane purchased if it has been reprocessed. Simply said, dialysis facilities and regulatory agencies that oversee their operation in the USA do not require the levels of process control or quality surveillance that are required of manufacturers before a product is used to treat patients.
http://ndt.oxfordjournals.org/cgi/content/full/19/11/2823
cschwab:
Abandoning Peracetic Acid-Based Dialyzer Reuse Is Associated with Improved Survival
1. Eduardo Lacson Jr,
2. Weiling Wang,
3. Ann Mooney,
4. Norma Ofsthun,
5. J. Michael Lazarus,
6. Raymond M. Hakim
+ Author Affiliations
1.
Fresenius Medical Care
cschwab:
Beta(2)-microglobulin clearance decreases with Renalin reuse.
(increased risk of Amyloidosis)
Castro R, Morgado T.
Unidade de Hemodi
cschwab:
UpToDate
Official reprint from UpToDate
cschwab:
A deadly error: Routine dialysis leads to Heights woman's death
Published: Saturday, October 04, 2008, 10:51 PM Updated: Monday, October 06, 2008, 9:02 AM
Lynn Moore | The Muskegon Chronicle By Lynn Moore | The Muskegon Chronicle
Chronicle/Kendra Stanley-Mills
"He's the only thing keeping me going," said James Allen of his dog, Duke, shown in the background. Allen, 72, of Muskegon Heights, lost his wife, Betty, after a mistake was made at a dialysis clinic. "He's my baby," Allen said of Duke. "He's all I've got."
It is too much for James E. Allen to talk about the day his wife died -- the day she left for her regular dialysis treatment and never came home.
By the numbers
69: Muskegon County residents newly diagnosed with end stage renal (kidney) disease in 2007.
197: County residents undergoing dialysis for chronic renal failure as of Dec.31, 2007.
17,000: Estimate of county residents with diabetes.
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