Occurrence of endotoxin in dialysis fluid from 39 dialysis units

Endotoxin exposure during haemodialysis may cause acute and chronic adverse reactions. In order to estimate the risk to the patient, samples of dialysis fluid from 39 of the 45 dialysis units in Sweden were analysed by the chromogenic Limulus amoebocyte lysate assay. Higher levels were obtained after the usual weekend shutdowns. The length of the tubing delivering the reverse osmosis water seemed to influence the extent of contamination. Fifty-nine percent of the units showed low mean endotoxin levels (i.e. mean concentration below the recommended limit in Sweden: < 25 ng l-1), while 18% of units had high levels (mean concentration > 100 ng l-1).