Hemodialysis, peritoneal dialysis, and related therapies for renal dialysis and the elderly/technology Page: 54
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OTA Manuscript - 54 -
lesser risk of causing allergic reactions, is associated with a
lesser degree of leukopenia during dialysis, and is generally better
tolerated (206). In recent years automated equipment has been
developed for cleaning and disinfection of dialyzers, and this
equipment can also check dialyzer functions such as fiber bundle
volume and ultrafiltration rate.
The use of formaldehyde as the disinfecting agent for reuse of
dialyzers has been one major cause of concern. Recently, the Center
for Disease Control has recommended use of a 4% formaldehyde solu-
tion for dialyzer reprocessing because of seasonal variation in the
risk of bacterial contamination with relatively resistant organisms
such as the mycobacterium species. Use of 4% formaldehyde solution
requires a larger volume of rinsing fluid to remove formaldehyde
from the dialyzer, and testing is necessary to insure that there has
been complete removal prior to connection to the patient. Four
percent formaldehyde is an unpleasant substance to work with, and
spills require special handling. Development of antinuclear-like
antibodies may occur as a response to residual formaldehyde reaching
the patient, and these antibodies have been implicated as a cause of
hemolysis in some dialysis patients (207). Because of these and
other problems, new disinfectants such as Alcide are being examined
as possible replacements for formaldehyde.
Another concern with reuse is the possibility of inadequate
dialysis, either because of diminished effective membrane surface
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Blagg, Christopher R. & Fenn, Scott. Hemodialysis, peritoneal dialysis, and related therapies for renal dialysis and the elderly/technology, report, January 1988; (https://digital.library.unt.edu/ark:/67531/metadc97377/m1/55/: accessed April 25, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.