Dialysate quality: new standards require a new approach to compliance
David A Fendley1, Richard A Ward
1Department of Medicine, University of Louisville, Louisville, Kentucky 40202-1718, USA.
Seminars in Dialysis
|September 22, 2012
Summary
New hemodialysis (dialysis) standards lower allowable bacteria and endotoxin levels in dialysate. Facilities must enhance water treatment and quality management systems to meet these improved patient safety requirements.
Area of Science:
- Nephrology
- Water Treatment Technology
Background:
- Contaminants in drinking water pose risks to hemodialysis patients if not removed during dialysate preparation.
- Established standards previously defined acceptable contaminant levels in dialysate.
Purpose of the Study:
- To summarize recent revisions to dialysate standards, focusing on microbiological contaminants.
- To highlight the impact of improved dialysate quality on patient outcomes.
Main Methods:
- Review of updated standards for hemodialysis water and dialysate.
- Analysis of changes in maximum allowable levels for bacteria and endotoxin.
- Examination of new requirements for quality management systems.
Main Results:
- Chemical contaminant limits remain unchanged.
- New standards specify a more sensitive bacterial culture method.
- Maximum allowable levels for bacteria and endotoxin in dialysate have been reduced.
Conclusions:
- Revised standards necessitate advanced water treatment and quality management in dialysis facilities.
- Implementing facility-specific quality management systems is crucial for meeting new microbiological requirements.
- Enhanced dialysate quality is linked to improved patient outcomes in hemodialysis.
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