Multiple use of dialyzers: safety and efficacy.

The practice of multiple use of dialyzers was examined over a 15-month period on all 104 patients in a chronic maintenance hemodialysis facility. A computerized medical information system permitted analysis of the incidence of events in over 10,000 successive hemodialyses. It also allowed analysis of the events in 27 patients dialyzed for a total of 655 months successively in two units practicing single and multiple dialyzer use. The incidence of complications during dialysis, of complications that might be related to infection, and the rate of hospitalization was not greater when the 27 patients were dialyzed in the unit practicing multiple use as compared with the rates in the unit practicing single use. Events possibly associated with infection did not occur more frequently during dialyses in which the dialyzer had been used between 2 and 20 times than they did with the initial use of the dialyzer. With successive dialyzer use, there was no significant change in the ability to remove fluid or in the dialysance of urea and creatinine. The neutropenia that characteristically occurs early in dialysis was substantially less with reused dialyzers than with their initial use. Under the operating conditions described, we conclude that multiple dialyzer use over a 15-month period is safe, efficacious, and is not associated with an increased rate of infection, of morbidity from any cause, or of mortality.