Dialysis in freestanding facilities reprocessing dialyzers with peracetic/acetic acid may be associated with worse survival than dialysis in freestanding facilities not reprocessing dialyzers or in those reprocessing with formaldehyde. The authors were unable to determine whether these relationships arose from greater comorbidity among patients treated in facilities using peracetic/acetic acid, poor quality of dialysis procedures in these facilities, or direct toxicity of peracetic/acetic acid. These findings raise important concerns about potentially avoidable mortality among U.S. hemodialysis patients treated in dialysis facilities reprocessing hemodialyzers.
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