WATER-TREATMENT FOR HEMODIALYSIS

Water treatment is a vital aspect of hemodialysis in which knowledge a nd technical skills are of utmost importance. The recognition that non tuberculous mycobacteria can be resistant to certain germicides spurre d the establishment of the current safety microbiologic standards for dialyzer reprocessing. Monitoring the dialyzer membrane integrity is a s important as meeting the standards for bacterial and endotoxin level s for dialyzer reprocessing. Ensuring the use of product water that me ets the chemical and microbiologic standards of the Association for th e Advancement of Medical Instrumentation is necessary to reduce the in cidence of endotoxemia and chemical hazards associated with the use of water for hemodialysis. The pathogenesis of febrile reactions during hemodialysis remains controversial. The weight of evidence, however, f avors transmission of endotoxin fragments across dialysis membranes to induce mononuclear cell cytokine production.