Document Detail

Reprocessing dialysers for multiple uses: recent analysis of death risks for patients.
MedLine Citation:
PMID:  15316099     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reprocessing dialysers is a common cost-saving practice in the USA. It began when patients were treated with bio-incompatible cellulosic membranes that were associated with medical complications, but has continued for economic reasons despite the current use of more biocompatible non-cellulosic membranes. A dialysis services and product provider using primarily its own non-cellulosic membranes recently embarked on a staged programme to stop reprocessing dialysers. Approximately a quarter of 71,000 patients had been switched from reuse to single use by July 1, 2001. The transition offered a unique opportunity to re-evaluate death risk associated with the reuse practice. METHODS: Patients were classified as reuse or single use as of July 1, 2001. Survival time measurements started on that date (Lag0) and at four 30 day intervals after it (Lag30, Lag60, Lag90 and Lag120). Thus, patients must have been treated in their reuse group after Lag0 for at least 30, 60, 90 or 120 days, respectively. Survival time was evaluated during 1 year following the lag date using the Cox method in unadjusted, case mix-adjusted and case mix plus other measure-adjusted models. RESULTS: All analyses suggested favourable survival advantage among patients treated with single use dialysers. The differences were statistically significant at all lag times in the unadjusted models but became significant only at later lag times in the case mix- and case mix plus other measure-adjusted models. For example, single use/reuse hazard ratios in the case mix-adjusted models at Lag0-Lag120 were 0.96 (NS), 0.96 (NS), 0.94 (P = 0.02), 0.93 (P = 0.02) and 0.92 (P = 0.01), respectively. CONCLUSIONS: A risk benefit appears associated with abandonment of the dialyser reuse practice, although the benefit may lag behind the change. In the USA, the relative risk burden associated with the reprocessing of dialysers may have changed over time with the evolution of clinical practice.
Edmund G Lowrie; Zhensheng Li; Norma Ofsthun; J Michael Lazarus
Related Documents :
3397579 - Peritonitis in children on continuous ambulatory peritoneal dialysis.
20190029 - Impact of c-reactive protein and pulse pressure evaluated at the start of peritoneal di...
19573669 - Patterns of postoperative enterocolitis in children with hirschsprung's disease combine...
16809889 - Frequency of hypoferritinemia, iron deficiency and iron deficiency anemia in outpatients.
19506469 - Outcomes of vascular access creation prior to dialysis: building the case for early ref...
3510479 - Washing with or without chloramphenicol in the treatment of peritonitis: a prospective,...
21326239 - Auxological changes in uk survivors of childhood acute lymphoblastic leukaemia treated ...
15057529 - Management of hardware infections following deep brain stimulation.
18704439 - A prospective comparison of laparoscopic and robotic radical nephrectomy for t1-2n0m0 r...
Publication Detail:
Type:  Journal Article     Date:  2004-08-17
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  19     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-21     Completed Date:  2005-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2823-30     Citation Subset:  IM    
Fresenius Medical Care (North America), Lexington, MA 02420-9192, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Cluster Analysis
Equipment Reuse
Middle Aged
Renal Dialysis / instrumentation*,  mortality
Risk Adjustment
Risk Assessment
Reg. No./Substance:
0/Polymers; 0/Sulfones; 25135-51-7/polysulfone P 1700

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Renal cell carcinoma co-existent with other renal disease: clinico-pathological features in pre-dial...
Next Document:  Socio-personal factors influencing public attitude towards living donation in south-eastern Spain.