Ultrapure dialysis fluid - How pure is it and do we need it?

Nephrology Dialysis Transplantation

Volumn 22, Issue 1, 2007, Pages 20-23

  Ledebo, Ingrid ^a  

^a Gambro AB   (Sweden)

Author keywords

Bacterial count; Dialysis fluid; Endotoxin; Ultrapure

Indexed keywords

BETA 2 MICROGLOBULIN; C REACTIVE PROTEIN; DIALYSIS FLUID; ENDOTOXIN; HUMAN ALBUMIN; INTERLEUKIN 6;

BACTERIAL COUNT; BACTERIAL GROWTH; BACTERIUM COLONY; DIALYSATE; DIALYSIS MEMBRANE; GROWTH INHIBITION; HEMODIALYSIS; HUMAN; KIDNEY DISEASE; MICROBIAL CONTAMINATION; NOTE; PRIORITY JOURNAL; STANDARD; ULTRAFILTRATION;

COST-BENEFIT ANALYSIS; DIALYSIS SOLUTIONS; HEMODIAFILTRATION; HUMANS; INFECTION CONTROL; KIDNEY FAILURE, CHRONIC; KIDNEY FUNCTION TESTS; RENAL DIALYSIS; ULTRAFILTRATION;

EID: 33846009464     PISSN: 09310509     EISSN: 14602385     Source Type: Journal    
DOI: 10.1093/ndt/gfl574     Document Type: Note

References (22)

1. Baz M, Durand C, Ragon A et al. Using ultrapure water in hemodialysis delays carpal tunnel syndrome. Int J Artif Organs 1991; 14: 681-685
2. Henderson L, Ward RA, Mion CM et al. Should hemodialysis fluid be sterile? Semin Dial 1993; 6: 26-36
3. European Pharmacopoeia 3rd Edition, Strasbourg, Council of Europe. 1997; 283-285
4. Ledebo I, Nystrand R. Defining the microbiological quality of dialysis fluid. Artif Organs 1999; 23: 37-43
5. European Best Practice Guidelines for Haemodialysis (Part 1), SECTION IV. Dialysis fluid purity. Nephrol Dial Transplant 2002; 17 [Suppl 7]: 46-62
6. Association for the Advancement of Medical Instrumentation: American National Standard. Water Treatment Equipment for Hemodialysis Applications: ANSI/AAMI RD62:2001. Arlington, VA: AAMI 2001
7. ISO Standard for fluids for hemodialysis and related therapies. Draft International Standard. ISO/DIS 23500, 2006
8. Ledebo I. Ultrapure dialysis fluid: Improving conventional and daily dialysis. Hemodial Int 2004; 8: 159-166
9. Pass T, Wright R, Sharp B, Harding GB. Culture of dialysis fluids on nutrient-rich media for short periods at elevated temperatures underestimates microbial contamination. Blood Purif 1996; 14: 135-45
10. Tsuchida K, Takemoto Y, Yamagami S et al. Detection of peptidoglycan and endotoxin in dialysate, using silkworm larvae plasma and Limulus Amebocyte Lysate methods. Nephron 1997; 75: 438-443
11. Lonnemann G. Assessment of the quality of dialysate. Nephrol Dial Transplant 1998; 13 [Suppl 5]: 17-20
12. Dinarello CA, Koch K, Shaldon S. Interleukin-1 and its relevance in patients treated with hemodialysis. Kidney Int 1988; 33 [Suppl 24]: S21-S26
13. Ward RA. Ultrapure dialysate. Semin Dial 2004; 17: 489-497
14. Masakane I. Review: Clinical usefulness of ultrapure dialysate - recent evidence and perspectives. Ther Apher and Dial 2006; 10: 348-354
15. Ledebo I. Clinical benefits of ultrapure dialysis fluid for hemodialysis. Hemodialysis Int 2006; in press
16. Stenvinkel P. Malnutrition and chronic inflammation as risk factors for cardiovascular disease in chronic renal failure. Blood Purif 2001; 19: 143-151
17. Lonnemann G. When good water goes bad: How it happens, clinical consequences and possible solutions. Blood Purif 2004; 22: 124-129
18. Schindler R, Beck W, Deppisch R et al. Short bacterial DNA fragments: Detection in dialysate and induction of cytokines. J Am Soc Nephrol 2004; 15: 3207-3214
19. Ledebo I. On-line preparation of solutions for dialysis: Practical aspects versus safety and regulations. J Am Soc Nephrol 2002; 13 [Suppl 1]: S78-S83
20. Guth HJ, Gruska S, Kraatz G. On-line production of ultrapure substitution fluid reduces TNF-alpha and IL-6 release in patients on hemodiafiltration therapy. Int J Artif Organs 2003; 26: 181-187
21. Vaslaki LR, Berta K, Major L et al. On-line hemodiafiltration does not induce inflammatory response in end-stage renal disease patients: results from a multi-center cross-over study. Artif Organs 2005; 29: 406-412
22. Ward RA, Sadler JH. Microbiological quality requirements for dialysate: is it time for a change? Nephrol News Issues 2002; 11: 26, 28-29, 33-34, 36, 38, 40, 73