The HEMO study revealed that β2-microglobulin clearance decreases over time with Renalin reuse in the high-flux group. It was suggested that the reuse of polysulfone or cellulose triacetate high-flux dialyzers with Renalin (without bleach) results in degradation of the high-flux capacity. At our haemodialysis unit (Vila Real, Portugal) we reused dialyzers until January 2000 (limited to 10 reuses), with an automatic machine Renatron® (Renal Systems, Minntech®). All of our 31 patients who started with postdilution haemodiafiltration on-line (HDFol) were always dialyzed with F-80 polysulfone (Fresenius®). The reposition rate was 10 litres/session until 1998 and 20 litres/session thereafter. Reuse techniques were abandoned in our country in January 2000 following an EEC directive. Thereafter, we have decided to maintain HDFol with the same dialyzers without reuse. The mean β2-microglobulin predialysis values did not decrease over time until reuse was terminated (1995 with low-flux haemodialysis: 25.4 ± 6.4 µg/l; 1997: 24.7 ± 6.6 µg/l; 1998: 29.2 ± 8.9 µg/l; 1999: 33.7 ± 4.7 µg/l) whereas β2-microglobulin clearances were reasonable with HDFol (1998: 56.4 ± 25.9 ml/min; 1999: 47.9 ± 16.4 ml/min). After stopping reuse we have noticed that predialysis β2-microglobulin values decreased (2000: 23.0 ± 3.9 µg/l) in accordance with β2-microglobulin clearance duplication (2000: 84.1 ± 25.0 ml/min; p < 0.01). It is our opinion that the reuse of polysulfone dialyzers with Renalin should be abandoned in the field of high-flux haemodialysis. It causes deterioration in the β2-microglobulin clearance and probably interferes with the high-flux haemodialysis benefits, namely the reduction of dialysis-related amyloidosis.

1.
Leypoldt JK, Cheung AK, Clark WR, et al: Characterization of low and high flux dialyzers with reuse in the HEMO study: Interim Report (abstract). J Am Soc Nephrol 1996;7:1517.
2.
Schulman G: Haemodialysis adequacy. Part 3. Htpp://www.hdcn.com/symp/nysn/971/schul2.htm
3.
WHO-IUS Nomenclature Sub-Comittee: Nomenclature of amyloid and amyloidosis. Bull World Health Organ 1993;71:105–110.
4.
Dantoine T, Castro R, Leblanc M, Bosc JY, Vaussenat F, Bouloux C, Canaud B: Popliteal cysts from advanced amyloidosis in long-term haemofiltration/haemodiafiltration. Nephrol Dial Transplant 1997;12:1512–1515.
5.
Cheung A, Leypoldt JK: Evaluation of hemodialyzer performance. Semin Dial 1998;11:131–137.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.