Is dialysis water a safe component for hemodialysis treatment in São Paulo State, Brazil?

Abstract

Failure on the water treatment poses hemodialysis patients at risk of injury and death. Identifying if the patients are exposed to water quality related microbiological risks is an important objective to reduce the mortality for chronic renal patients and is the main issue of this study. We evaluated the microbiological water quality used by 205 dialysis services in São Paulo State, Brazil between 2010 to 2016. The study included heterotrophic bacteria count, total coliforms research, and bacterial endotoxin determination in 1366 dialysis water samples. The number of unsatisfactory clinics for at least one microbiological parameter decreased 16.0% between 2010 to 2015 but increased 57.2% in 2016. In 2010, the most frequent unsatisfactory parameter was related to heterotrophic bacteria count (54.8%) followed by endotoxin determination (45.2%). However, in 2013 an opposite situation was observed: endotoxin determination as the parameter of the higher incidence of nonconformities. Total coliform was verified at a lower frequency. We highlighted the importance of regular monitoring of dialysis water quality to prevent infections caused by dialytic procedures and to ensure that the water is a safe component of the treatment.

Water treatment for hemodialysis in Baghdad medical city, Iraq

“…The acceptable international maximum allowable level of bacteria (˂100 CFU/ml) or the action level (˂50 CFU/ml) (ANSI/AAMI 23500 2019; ISO 23500 2019). To keep the bacterial count below the action level, a regular and effective disinfection procedure must be performed as part of the hygienic maintenance of the water treatment units (Hilinski et al., 2020).…”

Evaluation of Some Chemical Parameters of Hemodialysis Water: A Case Study in Iran

“… 10 - 12 In another study conducted by Suzuki et al 13 on the quality of dialysis water in Brazil, it was found that the concentration of copper, nitrate and aluminum in dialysis water is higher than the standard limits. The studies of Abualhasan et al 7 in Palestine, Vorbeck-Meister et al 14 in Vienna, Austria, Hilinski et al 15 in Brazil, Ocunola and Olaitan 16 in Nigeria and Jesus et al 17 in Riode Jeneiro, Brezil also showed that the quality of water used for hemodialysis patients was not up to standard.…”