The evolution of technological strategies in the prevention of dialysis water pollution: sixteen years' experience

Blood Purif. 2012;34(3-4):238-45. doi: 10.1159/000343127. Epub 2012 Nov 9.

Abstract

Aim: This report attempts to illustrate the positive impact on the quality of dialysis water produced over a 16-year period through the progressive optimization of technological procedures.

Methods: Fundamental steps included the following: elimination of polyvinyl chloride (PVC), periodical controls, introduction of stainless steel and/or polyethylene polymer and substitution of single-pass reverse osmosis (SRO) with double-pass reverse osmosis (DRO). Daily overnight automatic thermal disinfection of distribution piping rings represented the final step.

Results: A dramatic improvement was observed in 645 water samples obtained from distribution piping. The measures applied resulted in a significant improvement of water quality, featuring levels of colony-forming units per milliliter ranging from 247.4 ± 393.7 in the presence of PVC and SRO to 14.1 ± 28.0 with stainless steel and DRO and 2.8 ± 3.2 with cross-linked polyethylene thermoplastic polymer and DRO (p < 0.01).

Conclusions: Dialysis water should be viewed by nephrologists as a medicinal product, and every effort should be made to ensure a high-quality liquid.

MeSH terms

  • Hemodialysis Solutions / chemistry*
  • Hemodialysis Solutions / standards*
  • Hospital Units
  • Humans
  • Renal Dialysis / methods*
  • Renal Dialysis / standards*
  • Water Pollution / prevention & control*

Substances

  • Hemodialysis Solutions