The conversion of food into energy produces harmful toxic materials. The primary function of the kidneys is to filter out toxic waste. Kidneys also help to maintain the balance of water, acids, and electrolyte.
However, when the kidneys fail to function properly, patients have to resort to dialysis. Dialysis is a process of filtering blood with the help of a machine (hemodialysis) or fluid (peritoneal dialysis).
A dialyser is a filter encased in plastic and inserted into a holder of the dialysis machine. It is this filter that does the cleaning work. Dialyser contains a semi-permeable membrane. Blood and dialysate (special dialysis fluid) flow through this semi-permeable membrane from two opposite ends.
The counter-current flow of the blood and the dialysate helps remove waste and maintain the required concentration of different solutes. After the filtration process, the clean blood returns to the body, and the dialysate containing the waste products is drained off.
Reuse of dialyser
Hemodialyzer reuse is a practice of using the same dialyzer several times by a single patient. This practice has been prevalent in US since 1980s. The basic steps involved in dialyzer reprocessing are:
- cleaning performance testing
- Disinfection and sterilization
Dialyzer reprocessing can be done manually or by the use of automated equipment.
How long can the dialyser be reused?
The dialyzer can be reused as long as certain test parameters are maintained. The three important tests are:
- TCV or total cell volume
- Urea Reduction Ratio (URR)
TCV should always be at least 80% of what it was first, as per the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF's K/DOQI). The URR should be at least 65%, and Kt/V should be at least 1.2. As long as these parameters are maintained, the dialyser can be reused. The dialyser is marked with the patient's name so that no other patient uses it.
There are different sizes of dialysers that are recommended by the doctor based on the blood volume. Compared to 153 single-use dialysers on average, only 9.6 reuse dialysers are utilised in a year. This can reduce medical waste by more than 60 million pounds.
Doctors can make dialysis affordable in developing countries by recommending the reuse of dialysers. The cost of a dialysis machine can be Rs. 6.5 lakh on the upper side. Medical dialysers costs can range from Rs. 500 - Rs. 1500 on an average. Dialyser reprocessing machine may cost up to Rs. 5.5 lakh. These costs can be financed through innovative lending products like doctor loans available in the market.
Reusing dialyser will make dialysis affordable, which will increase the patient base for the doctor.
Additional read: 8 questions to ask while taking a doctor loan
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