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Hemodialysis and water quality.
Angela D Coulliette1, Matthew J Arduino
1Centers for Disease Control and Prevention, Atlanta, GA, USA. acoulliette@cdc.gov
Seminars in Dialysis
|July 18, 2013
Summary
Dialysis water quality is critical for patient safety, as contaminants can cause serious health issues. Adhering to established standards and monitoring systems helps prevent outbreaks and protect the 383,900+ U.S. hemodialysis patients.
Area of Science:
- Nephrology
- Public Health
- Medical Engineering
Background:
- Maintenance hemodialysis involves over 383,900 U.S. individuals exposed to water via dialysate.
- Water and dialysis solution quality are critical, linked to adverse patient outcomes.
- Contaminants in dialysis water pose significant health risks.
Purpose of the Study:
- To discuss the importance of the dialysis water distribution system.
- To review current standards, recommendations, and monitoring methods for dialysis water.
- To analyze historical outbreaks and infection control programs related to dialysis water contaminants.
Main Methods:
- Review of standards and recommended practices from the Association for the Advancement of Medical Instrumentation.
- Examination of Federal Regulations (Conditions for Coverage) by the Centers for Medicare and Medicaid Services.
- Analysis of documented chemical, bacterial, and endotoxin outbreaks in dialysis patients.
Main Results:
- Episodic outbreaks of chemical, bacterial, and endotoxin contaminants have affected dialysis patients since the 1960s.
- These outbreaks have resulted in at least 592 cases and 16 deaths in the U.S.
- Established standards and regulations aim to limit contaminants in dialysis water and fluids.
Conclusions:
- Strict adherence to water quality standards is essential for hemodialysis patient safety.
- Effective monitoring and infection control programs are crucial for preventing contaminant-related outbreaks.
- Ensuring the quality of dialysis water is a critical component of patient care and public health.
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