Cheung A K, Dalpias D, Emmerson R, Leypoldt J K
Renal Section, Veterans Affairs Medical Center, Salt Lake City, Utah.
Am J Nephrol. 1991;11(5):397-401. doi: 10.1159/000168345.
The benefits and disadvantages of hemodialyzer reuse is controversial. While biochemical data have suggested potential benefits from reuse, there is dispute over the clinical impact on the patient. Limited data show that reuse is associated with less intradialytic symptoms compared to first use. We conducted a prospective study of acute symptoms during clinical dialysis using new and reused cellulose acetate membrane hollow-fiber dialyzers. A total of 106 sessions using new dialyzers and 871 sessions employing reused dialyzers were monitored. Dialyzers were processed with an automated machine using hydrogen peroxide and peroxyacetic acid as sterilants. We found that, compared to new ones, reused dialyzers were associated with a similar frequency of overall and specific symptoms. In addition, there was no difference in the magnitude of changes in blood pressure during and after the treatments between the two groups. We conclude that maintenance hemodialysis with reused cellulose acetate membrane dialyzers processed with hydrogen peroxide and peroxyacetic acid was not associated with more or fewer subjective symptoms than dialysis with new dialyzers.
血液透析器复用的利弊存在争议。虽然生化数据表明复用有潜在益处，但对于其对患者的临床影响存在争议。有限的数据显示，与首次使用相比，复用与透析期间较少的症状相关。我们使用新的和复用的醋酸纤维素膜中空纤维透析器对临床透析期间的急性症状进行了一项前瞻性研究。共监测了106次使用新透析器的透析过程和871次使用复用透析器的透析过程。透析器用使用过氧化氢和过氧乙酸作为消毒剂的自动化机器进行处理。我们发现，与新透析器相比，复用透析器出现总体症状和特定症状的频率相似。此外，两组治疗期间和治疗后血压变化的幅度没有差异。我们得出结论，使用过氧化氢和过氧乙酸处理的复用醋酸纤维素膜透析器进行维持性血液透析，与使用新透析器透析相比，主观症状并未增多或减少。
