Water Treatment for Hemodialysis: What You Must Know to Keep Patients Safe

Glenda M Payne; Jim Curtis

Water Treatment for Hemodialysis: What You Must Know to Keep Patients Safe

Nephrol Nurs J. 2018 Mar-Apr;45(2):141-168.

Authors

Glenda M Payne^{1

2

3}, Jim Curtis^{4

5

6

7

8}

Affiliations

¹ Cofounder and Principal of the National Dialysis Accreditation Commission and a member of the Association for the Advancement of Medical Instrumentation (AAMI) Renal Disease and Detoxification Committee.
² She previously worked as a State and Federal surveyor for thirty years, served as a primary author of the Texas End Stage Renal Disease (ESRD) Licensing Rules and the Federal ESRD Interpretive Guidance, and member of the core faculty for surveyor training and tool development from 1989-2011.
³ charter member of ANNA's Dallas Chapter, and has served as Southeast Vice President, National Secretary, and President of ANNA.
⁴ Managing Partner of Jim Curtis and Associates, LLC.
⁵ co-founder of Outset Medical.
⁶ Past President of the National Association of Nephrology Technicians (NANT).
⁷ was previously a voting member of both the AAMI Renal Disease and Detoxification and the AAMI Medical Devices in Home Applications Committees.
⁸ editor of Water Treatment for Dialysis, published by the National Association of Nephrology Technicians/Technologists (NANT) in 2015.

PMID: 30303637

Abstract

It is critical for all staff members to work together to keep patients safe. Nephrology nurses with responsibility for hemodialysis (HD) need to know and understand the clinical ramifications of water treatment and dialysate preparation. Although some HD programs may have full-time technical staff who operate and test the water treatment and dialysate preparation systems, many programs rely on nursing staff members for the dayto- day operation and testing of these systems. This article details the reasons safe water and dialysate are critical for patients on HD; and reviews components of water treatment systems, dialysate concentrate preparation, and the monitoring and testing necessary to assure that both water and dialysate are safe for patient use. Integrated HD systems (i.e., those that combine water treatment and dialysate preparation and delivery in an individual machine "package") are also described.

Keywords: dialysate; hemodialysis; water testing systems; water treatment.

MeSH terms

Hemodialysis Solutions
Humans
Nephrology
Patient Safety*
Renal Dialysis*
Water Purification*

Substances

Hemodialysis Solutions