Dialyzer reuse and mortality risk in patients with end-stage renal disease: a systematic review.

Abstract:

BACKGROUND AND AIM:Robust evidence about dialyzer reuse effects on mortality is not available. Our aim was to summarize the evidence for the effectiveness of dialyzer reuse compared to single use in patients with end-stage renal disease. METHODS:We searched MEDLINE, Embase, CINAHL, SciELO, LILACS, USRDS ADR, universities' theses databases and annals of congress from major nephrology societies. Reviewers performed the study selection and data extraction independently. We used the GRADE approach to assess the quality of the evidence. Mortality was the primary outcome. RESULTS:A total of 1,190 studies were retrieved, and 14 were included in the review (n = 956,807 patients). The disinfectants used on dialyzer reprocessing were hypochlorite, formaldehyde, glutaraldehyde, and peracetic acid. The evidence available from the studies was of very low quality. Most studies found no differences between groups. In studies with statistically significant differences, these differences were not observed in all groups and they varied by the type of disinfectant, time of observation and treatment unit. CONCLUSIONS:No significant differences were identified for the superiority or inferiority of dialyzer reuse versus single use when assessing the mortality of patients with end-stage renal disease. Studies of higher quality, including randomized clinical trials, are required to provide conclusive evidence regarding the effectiveness and safety of dialyzer reuse.

journal_name

Am J Nephrol

authors

Galvao TF,Silva MT,Araujo ME,Bulbol WS,Cardoso AL

doi

10.1159/000336532

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

249-58

issue

3

eissn

0250-8095

issn

1421-9670

pii

000336532

journal_volume

35

pub_type

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