Comparison of Adequacy of Dialysis between Single-use and Reused Hemodialyzers in Patients on Maintenance Hemodialysis

Hamid, Arsalan; Dhrolia, Murtaza; Imtiaz, Salman; Qureshi, Ruqayya; Ahmad, Aasim

doi:10.29271/jcpsp.2019.08.720

Cited by 4 publications

(6 citation statements)

References 12 publications

(25 reference statements)

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“…These issues are believed to arise from the reprocessing procedure involving sanitizing agents [ 67 , 70 ]. However, two studies have indicated that single, minimal (>6 times), or multiple dialyzer reuse carries no impact on dialysis adequacy, body weight, and serum albumin level [ 71 , 72 ].…”

Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

et al. 2020

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Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

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Section: Iatrogenic Factors Of Malnutritionmentioning

confidence: 99%

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

et al. 2020

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“…The dialyzer reuse does not seem to affect the effectiveness of dialysis and is a widely used practice in countries with restricted resources. 15,16 In addition, although some studies show that the all-cause mortality in patients undergoing high flux dialysis may be lower compared to low flux hemodialysis, 15,17 this subject is still a matter of controversy. 18 The association of age and higher levels of bicarbonate had already been reported 3,18 and can be interpreted as a consequence of the lower acid generation in the dialysis interval due to the sarcopenia and reduced physical activity that can affect older hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metabolic acidosis in hemodialysis: a neglected problem in Brazil

2020

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Introduction: Metabolic acidosis is associated with the high mortality seen in hemodialysis patients. The panorama of metabolic acidosis in hemodialysis in Brazil is unclear since 1996 when the analysis of bicarbonate levels was no longer a compulsory exam. We aimed to establish the prevalence of metabolic acidosis in a hemodialysis population and analyze the factors associated with low bicarbonate levels. Methods: A cross-sectional study was carried out to assess the prevalence of metabolic acidosis in adults undergoing regular hemodialysis from January to April 2017, in four dialysis centers from Niteroi, Rio de Janeiro, Brazil, and surroundings. For blood gas analysis, samples of 2 mL were collected in heparinized syringes before a midweek dialysis session. Results: 384 patients with a mean age of 58.1 ± 15.8 years (54.5% men and 63.0%, non-white) were included. Approximately 30% had diabetes and 48%, hypertension. Nearly 88% used primary arteriovenous fistula as vascular access. The pre-dialysis mean serum tCO2 in the midweek session was 22.7 ± 3.0 mEq/L. The prevalence rate of serum bicarbonate below DOQI recommendation (22 mEq/L or higher) was 40.3%, and 6.5% had serum bicarbonate < 18 mEq/L. The dialyzer use count and the use of low-flux dialyzers were negatively associated whereas age and the standard Kt/V values were positively associated with the serum bicarbonate levels. Conclusion: The findings were in agreement with global data reported in previous studies. However, because the sample was relatively small and non-representative of the Brazilian population, a more comprehensive study, addressing national data is necessary to substantiate our findings.

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“…The highest was in the age range of 65-74 years with the percentage of 8.23‰ (13). In several previous studies related to routine hemodialysis patients, the average age of the research subjects was 43-59 years (9,12,(14)(15)(16)(17)(18).…”

Section: A the Effects Of Reuse Dialyzer Application On Hd Adequacy T...mentioning

confidence: 99%

The Impact of Reuse Dialyzer Application on Routine Hemodialysis Patients Adequacy and Its Correlation with Cost Efficiency in Type D Hospital

Ningtiyas

2023

AHJ

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Background: Hemodialysis (HD) is one of the high cost service unit in the hospital which it implemented the cost effciency policy by the application of reuse dialyzer. According to claim recieved from Jaminan Kesehatan Nasional (JKN) system, the HD procedure for type D hospitals received the smallest claim payment if it compared to type A, B and C hospitals. This policy will be measured its effect on the effectiveness in the form of Ureum Reduction Ratio (URR) and Kt/V values and it associated with cost efficiency in type D hospital settings. Objectives The aims of this study were to 1.) Measure the corellation between the policy of using reuse dialyzer and the HD adequacy value and 2.) Evaluate the cost efficiency policy implemented by type D hospital HD unit in the form of using reuse dialyzer. Methods: This study was conducted with a cross-sectional design study from URR and Kt/V data on routine HD patients at 4 of type D hospital in Yogyakarta and Cantral Java in period Januari-March 2021. HD adequacy values were compared between the groups using the new and reuse dialyser. Cost efficiency was calculated based on the cost difference between cost of the HD procedure using a reuse dialyser and the projected cost if it is carried out with a single-use dialyzer.Result and Discussion: HD adequacy data were obtained from 112 subjects consisting of 22 with a new dialyzer, 32 with a reused (R) dialyzer first and R2, 27 with R3-R4 and 31 with R5-R7.The analysis of the effect of using reuse dializer on URR and Kt/V in the group with the new and reuse dialyser was obtained p = 0,90 and 0,91. The HD adequacy value in using reuse dialyser was not significantly different from using the new dialyser. The result of the cost efficiency analysis was 20.55% with using reuse dialyzer when it is associated with a source of income for HD services in type D hospitals.Conclusion: The application of reuse dialyzer is proved that it did not affect HD adequacy achievement when it compared to the use of a new dialyzer, and saved costs on HD services in type D hospitals. Keywords: Hemodialysis, reuse dialyzer, HD adequacy, efficiency

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Comparison of Adequacy of Dialysis between Single-use and Reused Hemodialyzers in Patients on Maintenance Hemodialysis

Abstract: Objective: To evaluate performance of thin layer agar (TLA) 7H11 method for detection of ofloxacin (OFX) and kanamycin (KM) resistance in smear positive clinical specimens of patients with tuberculosis comparing the results with gold standard MGIT 960 system.

Cited by 4 publications

References 12 publications

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Metabolic acidosis in hemodialysis: a neglected problem in Brazil

The Impact of Reuse Dialyzer Application on Routine Hemodialysis Patients Adequacy and Its Correlation with Cost Efficiency in Type D Hospital

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