Tamil Nadu adopts single-use haemodialysis policy to improve patient safety

Tamil Nadu is set to do away with reuse of dialysers for patients undergoing dialysis in government hospitals. It is now adopting a “single-use haemodialysis policy” to enhance safety of patients.

The adoption of single-use dialysis policy, according to senior doctors, marks a milestone in the evolution of dialysis care in the public sector in the State. Issuing orders last week, the T.N. Health Department asked all government medical institutions to adopt the single-use dialysis policy, implementing it within the existing package rate of the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS).

Why the move

T. Balasubramaniyan, director, Institute of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, said that dialysers, commonly referred to as artificial kidneys, are thoroughly cleaned using chemicals and reused after 12 to 24 hours. However, there is a risk of residual chemical exposure to patients and potential cross-contamination. Outbreaks of Hepatitis B and C have also occurred. It is for these reasons that many countries and centres have moved to single-use dialysis to improve patient safety.

According to data as of 2025-2026, about 90% of haemodialysis treatments in the United States use single-use dialysers, while the figure is around 85% in Europe (excluding eastern Europe), and 98% in Australia and New Zealand. In India, reusable dialysers account for 70 to 80% of haemodialysis treatments in the government sector. Very few States have adopted single-use haemodialysis policy in India, he said.

“Only States such as Telangana, Karnataka and Gujarat have introduced the single-use dialyser policy. In Chennai, a majority of the corporate hospitals have moved on to single-use dialysers, and charge accordingly. Last year, the Tamil Nadu government had sent a team of doctors to Telangana to study the policy and submit a report. We, at Madras Medical College, sent a proposal to the government outlining that as per current practices, reusing dialysers is no longer safe, considering poor quality control measures. The dialyser efficiency also declines and patients stand the risk of chemical exposure and cross contamination,” Dr. Balasubramaniyan explained.

Single-use dialysers have the advantages of better efficiency, good patient safety and less risk of infection, he said.

Following best practices

“Across the world, large dialysis networks have increasingly moved toward single-use dialysers, prioritising infection control, consistency of dialysis dose, and safety,” said M. Edwin Fernando, professor and head of department, nephrology, Government Stanley Medical College Hospital (SMCH).

Since 2014, SMCH has not been reusing blood tubings, and from January 2025, it started to use single-use dialysers. “From August to now, we have observed that there are no seroconversions, and also no significant increase in biomedical waste generated,” he said.

Cost safety trade-off

Dialyser reuse represents a cost–safety trade-off, Dr. Fernando said, adding: “Economic advantages must be balanced against infection risk, chemical exposure, and reduced dialysis efficiency, which is why modern practice increasingly favours single-use dialysers.”

Dr. Balasubramaniyan said that it is economically viable as huge purchases are involved. With the government issuing necessary orders, all consumables necessary for dialysis will be purchased as single bundle dialysis kits. This will include the dialyser, AV line, AV needle, transducer protector and dressing kit.

Published – March 17, 2026 01:01 pm IST