The Changes of Solute Clearance Following Reprocess by Citric Acid and Heat for High-Flux Dialyzer Reuse / 대한신장학회잡지

ABSTRACT

BACKGROUND: The reprocess by citric acid and heat is an alternative to chemical reprocess for reusing dialyzers. However, there are little experience and data on the effect of reprocess by citric acid and heat on the solute clearance. METHODS: In the 34 chronic hemodialysis patients using low flux dialyzers, solute clearance was measured after reprocessing high-flux dialyzers by citric acid and heat. Dialyzers were reprocessed using 1.5% citric acid solution heated to 95degrees C for 20 hours. The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were measured at single use and during reuses for 5,10,15,20 and 25 times. RESULTS: The clearance and reduction rate of urea, beta2-microglobulin, osteocalcin and myoglobin were significantly greater with high-flux dialyzer compared with low flux dialyzer, which were maintained after dialyzer reuse. beta2-microglobulin clearance was increased at 10th and 20th reuse and beta2-microglobulin reduction rate was increased at 10th, 20th and 25th reuse compared with the single use. Myoglobin clearance and reduction rate were increased after the 5th reuse compared with the single use. Albumin loss to dialysate was gradually increased following reuses. Of the 34 dialyzers studied, 14 were discarded before the 25th reuse because of inadequate performance test. CONCLUSION: Reprocessing high flux dialyzers by citric acid and heat increases middle and large molecule clearance and was safe.