Effect of dialyzer reprocessing methods on complement activation and hemodialyzer-related symptoms. 1987

F Dumler, and G Zasuwa, and N W Levin

The effects of different dialyzer processing methods and of reuse on complement activation and dialyzer-related symptoms were studied in 96 maintenance hemodialysis patients. New dialyzers were either unprocessed (Group 1) or machine-washed with bleach and stored in formaldehyde (Group 2). Reused dialyzers were manually cleansed using the combination of bleach and formaldehyde (Group 3), or machine-washed in formaldehyde (Group 4) or peracetic acid (Group 5). Prewashed new dialyzers (Group 2) were associated with greater complement activation during dialysis when compared with unprocessed, new dialyzers (Group 1) (p less than 0.05). Reused, unbleached but formaldehyde-treated or peracetic acid-treated dialyzers (Groups 4 and 5) were associated with reduced complement activation (p less than 0.05). Complement activation was not reduced when bleach was used for reprocessing (Group 3). The percentage of patients without symptoms during dialysis was significantly greater with reused dialyzers than with new dialyzers (Groups 3 through 5 versus Groups 1 and 2; 39 versus 25%; p = 0.035). The severity of total symptoms correlated significantly (p = 0.0004) with complement activation. Our results suggest that total symptoms during dialysis are correlated with the degree of complement activation. However, trends in the data pertaining to chest pain suggest that factors other than complement activation may be important in the pathogenesis of some dialyzer-related symptoms.

UI MeSH Term Description Entries
D006997 Hypochlorous Acid An oxyacid of chlorine (HClO) containing monovalent chlorine that acts as an oxidizing or reducing agent. Hypochlorite,Hypochlorous Acids
D007688 Kidneys, Artificial Devices which can substitute for normally functioning KIDNEYS in removing components from the blood by DIALYSIS that are normally eliminated in the URINE. Artificial Kidney,Kidney, Artificial,Artificial Kidneys,Blood Dialyser,Blood Dialyzers,Hemodialyser,Hemodialyzers,Renal Dialysis Machine,Blood Dialysers,Blood Dialyzer,Dialyser, Blood,Dialysers, Blood,Dialysis Machine, Renal,Dialysis Machines, Renal,Dialyzer, Blood,Dialyzers, Blood,Hemodialysers,Hemodialyzer,Machine, Renal Dialysis,Machines, Renal Dialysis,Renal Dialysis Machines
D007958 Leukocyte Count The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells. Blood Cell Count, White,Differential Leukocyte Count,Leukocyte Count, Differential,Leukocyte Number,White Blood Cell Count,Count, Differential Leukocyte,Count, Leukocyte,Counts, Differential Leukocyte,Counts, Leukocyte,Differential Leukocyte Counts,Leukocyte Counts,Leukocyte Counts, Differential,Leukocyte Numbers,Number, Leukocyte,Numbers, Leukocyte
D010463 Peracetic Acid A liquid that functions as a strong oxidizing agent. It has an acrid odor and is used as a disinfectant. Acetyl Hydroperoxide,Peroxyacetic Acid,Desoxone-1,Dialax,Peracetic Acid, Sodium Salt,Peroxyethanoic Acid,Sodium Peracetate,Zinc Peracetate,Acid, Peracetic,Acid, Peroxyacetic,Acid, Peroxyethanoic,Desoxone 1,Desoxone1,Peracetate, Sodium,Peracetate, Zinc
D011537 Pruritus An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. Itching,Pruritis
D002637 Chest Pain Pressure, burning, or numbness in the chest. Precordial Catch,Precordial Catch Syndrome,Texidor's Twinge,Chest Pains,Pain, Chest,Pains, Chest,Syndrome, Precordial Catch,Texidor Twinge
D003167 Complement Activation The sequential activation of serum COMPLEMENT PROTEINS to create the COMPLEMENT MEMBRANE ATTACK COMPLEX. Factors initiating complement activation include ANTIGEN-ANTIBODY COMPLEXES, microbial ANTIGENS, or cell surface POLYSACCHARIDES. Activation, Complement,Activations, Complement,Complement Activations
D003902 Detergents Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. Cleansing Agents,Detergent Pods,Laundry Detergent Pods,Laundry Pods,Syndet,Synthetic Detergent,Agent, Cleansing,Agents, Cleansing,Cleansing Agent,Detergent,Detergent Pod,Detergent Pod, Laundry,Detergent Pods, Laundry,Detergent, Synthetic,Detergents, Synthetic,Laundry Detergent Pod,Laundry Pod,Pod, Detergent,Pod, Laundry,Pod, Laundry Detergent,Pods, Detergent,Pods, Laundry,Pods, Laundry Detergent,Synthetic Detergents
D005557 Formaldehyde A highly reactive aldehyde gas formed by oxidation or incomplete combustion of hydrocarbons. In solution, it has a wide range of uses: in the manufacture of resins and textiles, as a disinfectant, and as a laboratory fixative or preservative. Formaldehyde solution (formalin) is considered a hazardous compound, and its vapor toxic. (From Reynolds, Martindale The Extra Pharmacopoeia, 30th ed, p717) Formalin,Formol,Methanal,Oxomethane
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses

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