What is the rationale for rinsing the blood compartment of a RENALIN sterilant-reprocessed dialyzer with 500 ml of sterile normal saline to drain before initiating dialysate flow to the dialyzer?
A. The RENALIN dialyzer-rinse procedure recommends a 500 ml saline flush to drain through the blood compartment prior to commencing dialysate flow and the ultrafiltration phase of the rinse procedure. The primary recommendation for this saline flush is to prevent formation of gas bubbles within the dialyzer’s hollow fibers. This can occur when bicarbonate (base) from the dialysate diffuses into RENALIN-filled (peracetic acid) fibers. The resulting acid-base reaction results in liberation of gas within the fibers, which may subsequently obstruct flow through these fibers. Fibers fully or partially obstructed with air are more difficult to rinse and the phenomenon may not be clearly evident from residual test procedures, because the bulk of saline being recirculated will be from unobstructed, more completely rinsed, fibers. In addition, gas bubbles trapped in the dialyzer fibers may be dislodged later during dialysis, exposing poorly rinsed surfaces to the patient’s blood. This rinse pro
