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Ultrapure dialysate: a desirable and achievable goal for routine hemodialysis

R A Ward1

  • 1Department of Medicine, University of Louisville, Kentucky 40202-1718, USA. richard.ward@louisville.edu

Seminars in Dialysis
|December 29, 2000
PubMed

Insights

Current US standards for hemodialysis fluid are outdated. Using ultrapure dialysate can reduce inflammation and complications like beta2-microglobulin amyloidosis, making it a necessary standard of care.

Area of Science:

  • Nephrology
  • Infectious Disease
  • Biomedical Engineering

Background:

  • Current US standards for dialysate microbiologic quality are over 20 years old and not stringent.
  • Bacterial products in dialysate can cross membranes, causing inflammation in hemodialysis patients.
  • Inflammation is linked to complications in long-term hemodialysis.

Purpose of the Study:

  • To evaluate the need for updated dialysate quality standards.
  • To highlight the benefits of ultrapure dialysate in reducing hemodialysis complications.

Main Methods:

  • Review of existing literature on dialysate quality, bacterial translocation, and inflammation.
  • Analysis of technological advancements in water treatment and dialysis machine design.
  • Assessment of the impact of ultrapure dialysate on patient outcomes, specifically beta2-microglobulin amyloidosis.

Main Results:

  • Bacterial products crossing dialysis membranes can trigger inflammatory responses.
  • Ultrapure dialysate has demonstrated efficacy in reducing beta2-microglobulin amyloidosis incidence.
  • Technological advancements permit routine production of ultrapure dialysate.

Conclusions:

  • Outdated dialysate standards pose risks to hemodialysis patients.
  • The use of ultrapure dialysate should be adopted as a new standard of care.
  • Implementing ultrapure dialysate can mitigate inflammation-related complications in hemodialysis.

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