Randomized Controlled Crossover Trial to Evaluate the Efficacy of Rinsing Techniques for Removal of Disinfectant in Hemodialyzer

Abstract

BACKGROUND: Peroxyacetic acid solution (PAA) has come into widespread use as a dialyzer germicide after the hemodialyzer reprocessing and reusing has been frequently practiced in many settings globally. A recirculation technique which is an existing rinsing preferred by users to obliterate residual chemical for the pre-dialysis process. However, there is uncertainty whether with and without recirculation is most effective due to a paucity of high-quality data. OBJECTIVE: To assess the rinsing techniques whether remaining chemical has been gotten rid of properly from the hemodialyzer among different manners. METHODS: A crossover design was used to determine whether the non-recirculation technique is equivalent to the recirculating technique for efficient clearance of the chemical debris in a dialyzer. Reused dialyzers were the randomized objects for the experiment, retrieved from enrolled patients who were treated with hemodialysis. The orderings of the rinsing procedure were randomised into two arms (recirculating versus non-recirculating techniques). The main measures of technique performance were peracetic residuals. RESULTS: A total of 24 reused hemodialyzers were recruited from chronic hemodialysis patients and randomised, 12 to each arm in which without carryover effect were aliased in each other. Nevertheless, using a non-recirculating method decreased the odds of having germicide (PAA) residues by roughly 7% (p > 0.10). The results from both equivalence tests were statistically equivalent. A peak level of PAA was detected in the time-series at 10 minute with given a beta coefficient of 1.15 (95% CI [0.22-2.09]). These values indicated rebound effects. CONCLUSION: The capacity to elimination of PAA residuals of the non-recirculating technique was as effective as that of the recirculation technique despite rebound effects.