Anyone else using central delivery of acid for haemodialysis?

Frances Mortimer's picture

The British Journal of Renal Medicine is interested in articles about local green initiatives.  I am writing one this week and thought i would base it on waste reduction in delivery of acid concentrate for haemodialysis.  This could cover central delivery (as in Bradford) as well as 44:1 concentrate (as in Kent), and SmartBags instead of cannisters.

It would be really helpful to know of anywhere else that is already using or planning to switch to central delivery.  Also any feedback on experiences with switching to 44:1 concentrate or SmartBags.

Thanks very much!

Frances

Comments

SmartBags

James Dixon's picture

Hi Frances,

I can offer feedback on our trial of the SmartBags if you wish.

In essence the trial was successful. However, we are still using 5L cans because the bags are currently produced in Germany and the Fresenius UK acid production facility does not offer the SmartBags at this point in time. The extra cost and carbon produced by shipping these over means the project is prohibitive until a UK produced option is available.

We have lent our support to the business case for UK production and I think another large unit in London has followed our lead. Hopefully this will drive forward the necesary changes to make it happen.

James

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Do SmartBags come in 44:1?

Frances Mortimer's picture

Thanks James, that's really helpful.  Do you know, are the SmartBags currently supplied in the higher concentration (hence smaller volume) of 44:1?

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SmartBags

James Dixon's picture

Hi Frances,

Yes the SmartBags come as 4.7L of 44:1 acid concentrate. These act as a direct replacement for our 5L cans of 44:1 which I think we have been using for a few years and is our most common acid used on the unit.

James

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central acid

Fraser Gilmour's picture

Hi Frances,

we are currently looking at options for acid concentrate handling following a waste audit. We switched from 6L 1:34 to 5L 1:44 concentration acid about a year ago but it was only recently brought to our attantion the amount of leftover acid which is being discarded after each treatment. Measurements show that we are disposing of around 23% of all the acid concentrate we buy in. I am working on an options paper at present to look at reducing this. Retrofitting a central acid distribituion system will be included along with some other options. 

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We are in the process of

Ben Wilson's picture

We are in the process of pricing up central acid delivery at the moment. We have the quote for the work we just need to work out our current costs and wastege, any cost savings, ROI and identify a suitable location to store the tanks. A little bit of work to do yet but hopefully there will be some progress over the next couple of months.

 

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Central Delivery business case

James Dixon's picture

Hi Ben,

Could you send me a bit more information on this? We are exploring this at our large unit in Newcastle, but as it sits in the PFI part of our site the costs of retrofitting a CD system in might be prohibitive.

This isn't going to stop me pricing it up, so I'd appreciate any data you compile on this.

Thanks,

James

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James, No worries. It is

Ben Wilson's picture

James,

No worries. It is still in its infancy so I haven't got much info as yet but if you drop me an email I'll keep you up to speed oon developments and then when I've got enough done I'll post a piece on the website.

benjamin.wilson@nhs.net

Cheers Ben

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central delivery at Royal London

Cyril Prince's picture

Hi Frances,

We have a central delivery system at the Royal London, it currently serves approx 100 points of use of these 70 of them are in regular use.

We are ordering roughly 4-5K litres per week of concentrate. As we have acute patients and others with specific requirements we probably have 85% of our patients on the Royal London site on central delivery while the rest use bottles.

We don't currently have it in any of our satellite units but plan to install it in all of our future units.

Kind regards.

Cyril.

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