What concern might arise from reprocessing dialyzers with bleach that increases membrane permeability?

The concern of increased risk of bacteria and endotoxins moving into the blood when reprocessing dialyzers with bleach arises from the potential for membrane damage and changes in its structure. Bleach can alter the integrity of the dialyzer membrane, leading to increased permeability. This increased permeability may allow not only the passage of larger solutes, like bacteria and endotoxins, but also other harmful substances that should normally be filtered out of the bloodstream.

Reprocessing dialyzers is designed to make them reusable, but if the reprocessing involves harsh chemicals like bleach, the risk is that the altered membrane no longer acts as an effective barrier. This scenario can lead to a dangerous situation where contaminants that should be retained in the dialyzer instead enter the patient's circulation.

Maintaining the integrity of the dialyzer membrane is crucial for ensuring patient safety and effective dialysis treatment, and any compromise to this integrity can significantly elevate the risk of adverse health effects during treatment.