Dialysis acid greener options

Eleanor Murray's picture

Some of our RDUs are not suitable for central acid, and even those that are will require a business case. Meantime we were hoping to achieve carbon and cost savings through reviewing our acid supplies (Fresenius options attached) – smaller bottles of higher concentrate meaning less plastic, less delivery emissions etc, but we have a question we hoped someone might answer…

Our estimates suggest that 6 litres of the 35x concentrate gives 210 litres of final dialysate, and the ‘A5’ 5 litres of 45x concentrate provides 225 litres i.e. 15 more litres.  However, previous use apparently caused inefficiencies, as some sessions required a second canister to be opened.  At face value this doesn’t make sense as total dialysate volume is 15L higher with the 45x...  

Does anyone know if a proportion of undiluted concentrate is lost at the start during machine set up??

Also, do all centers use ‘Optiflow’ or ‘dialysate flow adaption’ as standard for all their dialysis, and has anyone quantified reductions in dialysate? Though even then, 225 litres should provide enough dialysate for 450 minutes at 500ml/min flow (although some lost in priming and with backfiltration).

Comments

Hi Eleonor,

Fraser Gilmour's picture

Hi Eleonor,

Switching to the 45x concentrate will reduce the amount of plastic waste and should reduce emissions as the total liquid volume to be transported will be less. However, I would check with the supplier where the concentrate is manufactured as it may be that the concentrate you switch to is manuafactured further away, inadvertently increasing emissions.

I'm not familiar with the DBB-EXA, however all machines should proportion the concentrate depending on the set mix ratio, or use conductivity, so there shouldn't be an increased consumption. I don't know why you would have seen cans run out qucker than the 35x, as you say the total dialysis fluid yeald should be higher with 45x. Do you have techs on site to investigate?

We only use adaptive dialysis fluid flow in our centres with central acid supply. Where cans are used we set the machines for fixed flow rate to reduce waste when the remnants of the cans are discarded     

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Thank you - very helpful!

Eleanor Murray's picture

Thank you - very helpful!

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