Health and Tech: Single-use dialysers, a medical boon

Hyderabad: Technological advancements in the field of medicine have now made it possible to provide safer and better treatment alternatives, especially in government hospitals where the patient inflow is high and utmost caution to avoid infections is needed. One such technology adopted — before any other Indian State or private hospital in Hyderabad — by […]

Hyderabad: Technological advancements in the field of medicine have now made it possible to provide safer and better treatment alternatives, especially in government hospitals where the patient inflow is high and utmost caution to avoid infections is needed.

One such technology adopted — before any other Indian State or private hospital in Hyderabad — by the Telangana government was single-use dialysers along with free haemodialysis sessions for Chronic Kidney Disease (CKD) patients.

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In 2015-16, during the initial stages of the launch of the flagship free dialysis initiative in Telangana, senior government nephrologists in Hyderabad decided to go for single-use dialysers despite it being costlier than the traditional practice of reusing dialysers.

The decision to use a dialyser once for a dialysis patient, instead of reusing it for multiple kidney patients at government hospitals, has gone a long way in reducing infections which are traditionally high among kidney patients who on are on long-term dialysis.

So, what are dialysis and dialyser?

Dialysis replicates the function of kidneys and it is a process of removing toxins from the body when the kidneys fail to function. Dialysis helps in the removal of different kinds of toxins, surplus salt and other impure liquids from the body.

A dialyser is a component of a dialysis machine. It is an artificial filter containing fine hollow fibres that have microscopic pores in its walls. The pores are called semi-permeable dialysis membranes. The toxins are removed when the dialysis fluid flows through the artificial filter.

Till recently, dialysers were reused in dialysis as it was economical to do so. However, reusing dialysers is associated with the rise of infections, especially Hepatitis. Thanks to advancements in technology and innovation, the availability of single-use dialysers has improved. Although a bit expensive, all 83 free government-run dialysis facilities are equipped with single-user dialysers.

What are the advantages of single-use dialysers?

Single-use dialysers prevent the spread of infections among kidney patients who need long term dialysis support for survival. Usually, the infection happens when the tubes and the dialyser are used multiple times on multiple patients.

Earlier, government hospitals in Telangana used dialysers multiple times on a single patient. In this procedure, while the medical tubes that are used for dialysis are discarded, the dialyser is not. Instead, the patient’s name was written on it and stored for his/her next dialysis session. Typically, such dialysers are used at least 10 times on a single patient before going for a fresh dialyser.

This process involved a lot of manual labour for maintaining the dialysers, a clean place to store them and a very expensive re-processor machine to disinfect the dialyser. It also took a lot to train technicians in the safe handling of the dialysers and ensuring that they are stored in an infection-free zone.

Quite often, due to the involvement of the human factor, the use of a dialyser multiple times exposes kidney patients to infections. Sometimes, if a patient’s name is misspelt on the dialyser, it could create a situation where a dialyser meant for one patient gets inadvertently used for another.

There are still several privately-run dialysis units in Hyderabad that reuse dialysers eight-10 times on a patient. There are ample studies that have demonstrated that such a practice leads to heavy chemical exposure not only for the patient but even for the caregivers and those running the dialysis centre, including doctors, nurses and technicians.