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TO REUSE OR NOT TO REUSE?

An Economic Evaluation of Hemodialyzer Reuse Versus Conventional Single-use Hemodialysis for Chronic Hemodialysis Patients

Published online by Cambridge University Press:  20 May 2002

Braden J. Manns
Affiliation:
University of Calgary
Ken Taub
Affiliation:
University of Calgary
Robert M. A. Richardson
Affiliation:
University of Toronto
Cam Donaldson
Affiliation:
University of Calgary

Abstract

Objectives: To evaluate the cost-effectiveness of reusing hemodialyzers for patients with kidney failure on dialysis employing either a heated citric acid or formaldehyde sterilization method, in comparison to the standard practice of single-use dialysis.

Methods: A meta-analysis of all relevant studies was performed to determine whether hemodialyzer reuse was associated with an increased relative risk of mortality or hospitalization. A decision tree was constructed to model the effect of three different dialysis strategies (single-use dialysis, heated citric acid, and formaldehyde dialyzer reuse) on the costs and quality-adjusted life expectancy of “typical” hemodialysis patients. The cost of heated citric acid reuse was estimated from a center experienced with the technique. The cost of end-stage renal disease (ESRD) care, survival data, and patient utilities were estimated from published sources.

Results: There was evidence of a higher relative risk of hospitalization (but not mortality) for hemodialyzer reuse compared with single-use dialysis. Depending on the assumptions used, the cost savings that could be expected by switching from single-use dialysis to heated citric acid reuse were small, ranging from CAN $0–739 per patient per year.

Conclusions: ESRD programs can incorporate the results of this study based on their individual situations to determine whether hemodialyzer reuse is appropriate in their setting.

Type
Research Article
Copyright
© 2002 Cambridge University Press

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