To reuse or not to reuse? An economic evaluation of hemodialyzer reuse versus conventional single-use hemodialysis for chronic hemodialysis patients.

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.

• Authors: Braden J Manns, Ken Taub, Robert M A Richardson, Cam Donaldson
• Journal: International journal of technology assessment in health care (Int J Technol Assess Health Care) Vol. 18 Issue 1 Pg. 81-93 ( 2002) ISSN: 0266-4623 [Print] England
• PMID: 11987444 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Formaldehyde
• Citric Acid

Topics

• Canada (epidemiology)
• Citric Acid
• Decision Support Techniques
• Equipment Reuse (economics)
• Female
• Formaldehyde
• Health Care Costs
• Health Care Rationing
• Hospitalization
• Humans
• Kidney Failure, Chronic (economics, mortality, therapy)
• Male
• Quality of Life
• Quality-Adjusted Life Years
• Renal Dialysis (economics, instrumentation)
• Risk Factors
• Sterilization (methods)
• Technology Assessment, Biomedical