Does anyone have experience of using powder for local mixing of acid for haemodialysis?
At face value there appear to be significant financial and carbon savings to be made. It would be good to hear from other units about their experience - in terms of energy use for local mixing, cost savings or issues of quality control.
John Stoves (nephrologist in Bradford)
Dear Dr.Stoves,
Perhaps I could give you a manufacturers perspective?
Historically when acid and bicarb concentrate was selling at ~ 85p/litre over a decade ago in-house production was cost effective and several units such a Leeds St.James,QE Birmingham,Walsgrave,Sheffield Kidney Institute, and The Lister all had production facilies which worked very well.
However since the bottled price has plummeted to less than 50p/litre it is unlikely that that there would be any financial savings on standard acid concentrate.
We have looked into this recently for a UK customer who wanted to make Citrasate in-house but I was unable to find a CE marked off the shelf mixing machine produced in the EU and the only one I could find was by Rockwell in the US.
We still have the detailed proposals we drew up for installing a German made automated mixing system for St.James several years ago if you would like to see those and put in some up to date costings for a hypothetical exercise.
To me given the above, the greenest solution at the moment is bulk deliveries from the closest manufactuer i.e. FMC which cuts down on plastic can waste and fuel used for shipments,a recent poor example being the importation from as far away as Egypt.
Hope this helps.
Chris Pearson
c.pearson@healthtec.co.uk
It has now been drawn to my attention that there is a suitable mixing machine available in the EU called the ECOMix marketed by Medizin & Technik GmbH which we think may be associated in some way with the company we worked with several years ago.
This new system however looks as if it may only work with large pre-packed dry acid cartridges produced in Germany which may negate the Green credentials of producing here in the UK.
I would be interested to hear if anybody has any experience of this mixing device.
I've tried to contact Intermedt who manufacture the ECOMix but at the moment, without success, however I have managed to find another German company called Herco who have a similar but less sophisticated concentrate mixing system called "hercopur" where hopefully a customer can use their own concentrate dry powder formulation and will contact them today to see if they are interested in supplying the UK market.
We can supply dry Citrasate powder for this machine.
http://www.herco-dialyse.de/englisch/dia_konzmisch.php
Update 30th July 2013:
We have UK prices now both for the Herco acid mixing machine and for the MTN dry powder mix and can supply both for you to produce Citrasate citric acid concentrate in house.
Please contact me for details.
Hope this helps those who are looking at Greener options rather than shipping 1000's of acetic acid containers all over the country.
Regards,
Chris
c.pearson@healthtec.co.uk
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