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Abstract
To the Editor: Adverse effects of used, regenerated hemodialyzers have been noted,1 2 3 but little has been recorded concerning adverse reactions to new dialyzers, except for reports of reactions that result from the now obsolete practice by manufacturers of sterilizing dialyzers with formaldehyde.4, 5 I would like to call attention to the phenomenon of reactions to new dialyzers.The new-dialyzer syndrome may go unrecorded because of the complexity of factors that may cause reactions during hemodialysis (the blood tubing, the dialyzer, the water or concentrate used to make the di alysate, or the intravenous solution used to fill the extracorporeal blood circuit) and because of the variety of agents that could potentially cause adverse reactions (particulates, plasticizers, sterilant residuals or reaction products, residual hollow-fiber-bore fluid, pyrogens, or bacteria).In one instance, we were able to identify 2-chloroethanol, a byproduct of sterilization with ethylene oxide gas, in the fluid obtained from the blood compartment of the dialyzer of a patient who had a severe, immediate reaction on initiation of dialysis.6 Most dialyzer manufacturers recommend rinsing the new dialyzer with 1 to 2 liters of sterile saline before starting dialysis.