A new central supply system as alternative source for bicarbonate dialysate

Area of Science:

• Nephrology
• Microbiology
• Environmental Science

Background:

• Bicarbonate dialysis is crucial for efficient treatment.
• Current methods use prepacked powders or liquid concentrates in plastic containers, posing contamination risks and environmental concerns.
• A novel central supply system (CSS) utilizing large sterile tanks was developed to address these issues.

Purpose of the Study:

• To evaluate the risk of bacterial contamination in dialysate using a newly designed CSS.
• To assess the long-term reliability and safety of the CSS in a clinical setting.
• To determine the cost, workload, and environmental impact of the CSS compared to traditional methods.

Main Methods:

• Bacteriological sampling of reverse osmosis (RO) water, concentrates, and dialysate from a 30-bed dialysis unit over three months.
• Colony forming units (CFU) were quantified after 48-hour incubation.
• Continuous monitoring of the CSS for nine months without intermittent disinfection.

Main Results:

• No samples exceeded the international standard of less than 200 CFU/ml for dialysate safety.
• Bacterial counts consistently remained below 10 CFU/ml throughout the study period.
• Predominant species identified included Pseudomonas, corynebacteria, and enterobacter.

Conclusions:

• The novel central supply system (CSS) reliably provides bacteriologically safe bicarbonate dialysate.
• The CSS significantly reduces costs, decreases workload for staff, and minimizes environmental pollution from plastic waste.
• This system offers a safe, efficient, and sustainable alternative for bicarbonate dialysis fluid preparation.