Reuse

[Zach]

Now that all Fresenius dialysis centers no longer reuse their dialyzers, I was wondering if reuse is on the decline at other centers.

I know at my center, they stopped reuse about four years ago.


And thank God for that!!     



EDITED: Topic moved to proper section "Dialysis: Centers" - Epoman, Admin/Owner

[kitkatz]

I drive my center crazy as they have to get me Fresenius nonreuse dialyzers.  I am allergic to renalyn and some of the fibers in the dialyzers.  I cannot do reuse. It makes me ill.

[Epoman]

I know before I left Davita, they reused the dialyzers. I'm sure they still do to.   "But, but it's better for you" Yeah right take your "When we reuse the dialyzors it helps stop manufacturing particles from entering in your bloodstream" bullshit and reuse that. It has always been known that using a new "kidney" with each treatment is better. But Money talks and bullshit walks.  

Glad when I read a while ago that Fresnius was going to "single use" it made me respect that company a WHOLE lot more than Dav-allaboutthebottondollar-ita

Now the question is did Fresenius do it for patients well being or because they figured it would be cheaper in the long run with out needing a reuse team, reuse machines, chemicals, etc, etc.

[Hawkeye]

Now the question is did Fresenius do it for patients well being or because they figured it would be cheaper in the long run with out needing a reuse team, reuse machines, chemicals, etc, etc.

The answer is a little of column A, and a little of column B.  Improving the health and out come of the patient treatments has always been something that Fresenius says it strives to improve.  Single use dialyzers definitely fit that bill, but just the manufacturing process of the dials is cheaper let alone all the added headaches involved with the reuse process.  Fresenius still manufactures the reuse machines, but sells them to the competitors who wish to use them.

[John S.]

Zach, when I was at a hospital clinic, we reused for about the 8 years I was there. Now we moved to a free standing independent clinic and we no longer reuse.
john

[Joe Paul]

Some at my clinic still re-use their dialyzers, I do not.

[BigSky]

I am on resuse.

Never had a problem. 


After switching from new filters every session to reuse my kt/v actually jumped.
In fact the problems I had with new filters have been eliminated. 

They use our filters for 20 times max before a new one.  It is up entirely to each patient if they want to reuse or not..  Some use new some reuse.  Each patient is given the choice to make on their own.  At anytime the patient can either start to use reuse filters or stop the use and go back to new.

At one time there were some problems but most of that is gone now.  The last thing I read on it showed there was no increase in morbidity or mortality among dialysis patients who used reuse compared to new.

[Zach]

I think we may all need to come out to Big Sky Country!

Sounds like they have their priorities right.   

[Sara]

Joe's center reuses and he doesn't get a choice about it.

[angieskidney]

I don't think any centers in Canada reuse (someone else would have to verify that) but I know in my city there is no reuse at either dialysis center.

[Rerun]

I reuse.  OMG isn't everything about recycle, recycle, recycle!?? If it is cheaper then I will do it.  It may shave off $5 from the $3,000 per session. 

The line they told me 20 years ago was that when a filter is reused the holes get bigger and more toxins get out. 

OH NO.....spell check is gone!

[Hawkeye]

The line they told me 20 years ago was that when a filter is reused the holes get bigger and more toxins get out.

Close but definitely not right.  Yes the holes in the fiber get bigger, but but that means your blood is being cleaned less efficiently.  You might lose more toxins, but you are also losing other things that wouldn't normally be able to pass through.  It would be like saying everytime you wash pantyhose you get more holes in them so that makes them look better because you can see more of your leg.  Maybe a better example would be ringing out fresh cheese with cheese cloth.  When you squeeze it down really tight the water comes out through the cloth, but the cheese remains inside because the fibers are to small.  Put a few holes in it or makes those fibers further apart, and you will be losing some of that cheese too.

[Zach]

Here's more information about reuse from the American Association of Kidney Patients (AAKP)


http://198.104.149.102/aakp-library/Reuse-Hemodialyzers/index.cfm

[kevno]

Since I have been back on Heamo the unit have never reused a dialyzers/kidney. Went back on for a rest from CAPD in 97. Been back on heamo 3 x 4 hours a week since 2000. In the 70's we reused the dialyzer/kidney but they were 6 feet long and 2 feet wide   Plus you had to use a socket set to put the dialyzer together. I could do it nearly blindfolded at the age of 11years 

[angieskidney]

Since I have been back on Heamo the unit have never reused a dialyzers/kidney. Went back on for a rest from CAPD in 97. Been back on heamo 3 x 4 hours a week since 2000. In the 70's we reused the dialyzer/kidney but they were 6 feet long and 2 feet wide   Plus you had to use a socket set to put the dialyzer together. I could do it nearly blindfolded at the age of 11years 

Wow! How times have changed!!

Unless you are on blood thinners there should be no problem, but you will still bleed some if you get one.  On of the most important things you want to watch out for is that your tattoo parlor of choice uses new needles for each person.  You do not want a place that just autoclaves there needles.  They claim it "cleans" them, but there is too much room for human error for my liking.  Gross comparison, but that's like someone saying I just scrubbed the toilet you can drink out of it if you like.  It could never be "cleaned" enough for me.

Wouldn't flushing a reusable kidney pose the same risks?

Yes I agree completely.  There is too much room for human error in the "cleaning" process of dialyzers.  Reuse dialyzers should be tagged with the patients name so the same dial goes to that same patient for the life of that dial, so getting someone else's dial shouldn't be an issue.  Things do happen though, and most people won't own up to a mistake they just try to cover it up to save their butts.  When the dials are reused they use a very harsh and high level disinfectant to clean them.  The chemicals are so bad a gas mask has to be worn by the reuse tech so they can breath.  I believe this process to be better than just spinning or autoclaving all the blood out, but I would never allow a reuse dial to be used on me.

Ya I agree! I am just glad that my unit does not use the reuse system.

[AlasdairUK]

My centre does not reuse. I'm glad that they don't. I would be worried about getting somebody else's. I just need to look through my folder and I see other peoples notes filed away in mine. It would be just too easy to make a mistake and the consequences would be great.

[angieskidney]

My centre does not reuse. I'm glad that they don't. I would be worried about getting somebody else's. I just need to look through my folder and I see other peoples notes filed away in mine. It would be just too easy to make a mistake and the consequences would be great.

Wow! I remember when I was on PD I could see the notes in my file but now I don't have access to them now that I am on HD

I hope they don't screw up any of my files

[livecam]

When I was on dialysis my unit practiced reuse but patients had the option of opting out.  Reuse was strongly encouraged by the unit and patients who wanted a new dialyzer for each treatment were frowned on.  I went with the flow for a period of time but eventually demanded no reuse after a blood leak happened in a dialyzer that had been used 21 times.  I lost alot of blood and as a result my HGB nosedived.  Anyone familiar with this knows that it can take weeks to bring HGB back up to where it was before a blood loss event.  I always had concerns anyway about sanitation and risk of disease either from the dialyzer or the compounds used to clean it.  My records were always accessible.  They sat in a large notebook on top of the machine and could be examined at any time. 

[angieskidney]

My records were always accessible.  They sat in a large notebook on top of the machine and could be examined at any time. 

In my unit if it is not in the computer it just doesn't exsist.

[kitkatz]

My body opted out of reuse for me.  I have an allergy to either renalyn or the fibers in certain types of dialyzers.  I get real sick from it all. No more resue after they tried killing me off in 2004 by changing my dialyzer on me.

[Hawkeye]

My body opted out of reuse for me.  I have an allergy to either renalyn or the fibers in certain types of dialyzers.  I get real sick from it all. No more reuse after they tried killing me off in 2004 by changing my dialyzer on me.

If they don't rinse that cleaning agent out properly that can get you VERY sick, and though rare there are patients who have an allergic reaction to the fibers of dialyzers.  Fresenius just switched over to a new way of sterilizing their dials at the manufacturing plant because it was found that some people were having reactions to the old method.

[Zach]

Fresenius just switched over to a new way of sterilizing their dials at the manufacturing plant because it was found that some people were having reactions to the old method.

Is that gamma instead of EO?

[Hawkeye]

Is that gamma instead of EO?

No, it's not gamma and I'm not sure what EO is.  It used to be a chemical sterilization process.  Now they are using an electron beam sterilization process on their dialyzers.

[Zach]

Is that gamma instead of EO?

No, it's not gamma and I'm not sure what EO is.  It used to be a chemical sterilization process.  Now they are using an electron beam sterilization process on their dialyzers.

Sorry, I meant EtO= Ethylene oxide.


Electron beam sterilization (e-beam sterilization) is a commercially successful technology for sterilizing a variety of disposable medical devices with a wide range of densities.

The e-beam inactivates microorganisms either by causing microbial death as a direct effect of the destruction of a vital molecule or by an indirect chemical reaction. This is the same mechanism as in gamma irradiation, and the dose required is the same.

http://www.ebeamservices.com/steriliz.htm

As with any sterilant in a dialyzer, it needs to be flushed thoroughly (not just recirculated) with an entire bag of saline  (1,000 cc).

[Bajanne]

They don't reuse here in the BVI, but I am told that in my country, Barbados, at the General Hospital, they reuse.  In fact, one of my nurses here did a week course some years back in my country where they taught how to reuse.  I am not looking forward to having to reuse when I finally return to my country.  When I go now, I get dialysis at a private clinic where they don't reuse, but I will not be able to afford that when I finally relocate.  Hope they give me a choice, but don't expect that they do.  I will claim to be allergic to that ren.... thing.