Dialysis quality water is a process by which dialysis water of high quantity and purity is used to perform the dialysis treatment safely. This process is also called Haemodialysis which includes the restoration of acid-base and electrolyte balance, uraemic toxins of little molecular weight, and the removal of any fluid. This can be achieved by using a haemodialyser or an artificial kidney that contains semi-permeable membranes with contra-parallel dialysis fluid and blood flow. This helps to facilitate any physical processes.
Below we have provided 7 interesting facts that may provide more information about Dialysis Quality Water-
- The dialysis quality fluid contains treated water combined with the electrolyte concentrate, containing glucose and a buffer.
- The production of this dialysis quality water involves a process of filtration done in multiple steps. It requires multiple processing levels before it becomes sufficient or required quality that can be presented to the patient’s blood or the dialyzer membrane.
- The production of 150 liters of dialysis quality water requires treating up to 1000 liters of drinkable quality water. This processing leads to around 60 to 90 percent of the source water to be rejected as waste.
- The contamination of the dialysis quality water may be fatal to patients. Contaminants are exposed to the fluid when there is a breakdown in the fluid during the purification process.
- Ultrapure dialysis water contains more severe microbiological criteria compared to the standard dialysis quality water. The ultrapure dialysis water has become more relevant if you consider increasing the use of haemo-diafiltration on-line. This necessitates volumes of ultrapure water infused into the bloodstream of the patient without the conventional barrier protection of the dialyzer membrane.
- Additionally, theoretically, using high fluidity dialyzer membrane may allow fragments of bacteria to enter into blood compartments, thereby necessitating the further need for a more stringent water standard. If you use ultrapure water, it will improve the nutritional and inflammatory markers along with anemia.
- Conventionally, dialysis quality water contains endotoxin concentration which is required in the process of dialysis and the dialysate is required to be less than 2 EU/ml combined with the 1 EU/ml action level. But the AAMI (Association for the Advancement of Medical Instrumentation) recommendations 2011 lowered the standard of endotoxin concentration in the dialysis water to less than 0.25 EU/ml and less than 0.5 EU/ml in the dialysate.
For a quantitative measure to check dialysis water purity, one needs to carry out a comprehensive analysis. Theoretically, frequent testing is more likely to detect contamination. However, it is important to consider the costs involved in false positives and testing, especially when contaminants are collected. Moreover, it is important to consider the remarkable magnitude of redundancy that may be built in the system. It is important to consider the upstream failure in the system of filtration that is unlikely to violate both ultra and RO filters. The extent of the dialysis fluid treatment system may vary in different institutions with larger or additional filters, with the use of multimedia or deionization filters or duplicate ultra and automated filters.
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