Vitamin C Supplementation for the Elimination of Residual Peracetic Acid and Hydrogenperoxide in Reused Dialyzer

Abstract

Background: Peracetic acid (PAA) is the most popular disinfectant for dialyzer reuse processing. After the elimination of microbes by disinfectant, PAA residual must be disposed via normal saline replacement following the standard practice guideline. However, the PAA residual and its by-product, hydrogen peroxide (H₂O₂), can be found in the dialysis membrane. The continuous accumulation of these free radicals can result in various human pathogeneses. Fortunately, these free radicals can be destroyed by Vitamin C. Objective: This study aimed to compare the elimination of PAA and H₂O₂ residual of the reused dialyzer with or without vitamin C supplementations. Method: The experimental group with 83 reused dialyzers with 125 milligrams (500 microliters) of vitamin C and the control group with 50 reused dialyzers with 500 microliters of normal saline during the eliminated procedure were executed. Both free radical residuals had been documented by PAA and H₂O₂ test strips at 2, 30, 60, 120, 180 minutes, respectively. Result: As for the evaluation of both free radical residues in dialyzer reuse groups while the H₂O₂ residue could be detected in the control group with time-dependent manner. Nevertheless, the reused dialyzers of both groups were clear from PAA residue. Consequently, the present study could be concluded that although the PAA rapidly alters to H₂O₂, 125 milligrams of vitamin C had sufficiently removed these two free radicals. Moreover, data from adjusted characteristics of reused dialyzers receiving vitamin C could reduced the incidence of residual H₂O₂ by 17.3 percent at the level of confidence interval 95 percent from (-16.7) to (-17.9), p-value < 0.001, when compared to the reused dialyzers without vitamin C supplementation. Conclusion: The additional procedure with 125 milligrams of vitamin C supplementation into reused dialyzer during the process of standard practice guideline could sufficiently reduced the incidence of residual PAA and H₂O₂.