Current Situation of Endotoxin Retentive Filter

Tsuchida, Kenji; Nakamura, Masayuki; Yoshikawa, Kazuhiro; Murata, Jun; Takesawa, Shingo

doi:10.1159/000213495

Cited by 7 publications

(2 citation statements)

References 19 publications

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“…The endotoxin cutting filter is a highly efficient tool to maintain the dialysate solution flowing into the dialyzer clean and avoid the introduction of bacteria and endotoxins in the hemodialysis patient. 12,13 Our results also indicated the efficiency of the endotoxin cutting filter (Table 1). However, the filters are not changed regularly; moreover, they can break down anytime, and this can remain undetected.…”

Section: Discussionsupporting

confidence: 66%

An easy disinfection strategy for pipes connecting hemodialysis equipment

et al. 2020

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Introduction: A hemodialysis room has pipes connecting the console and central fluid equipment. While these pipes require disinfection, reports detailing disinfection strategies are unavailable. Therefore, we aimed to compare two easy disinfection strategies differing in sanitization frequency and sanitizer concentration. Methods: Reverse osmosis water (ROW) purifying equipment and six dialysis consoles were connected by 20 m of pipes. Only ROW flowed through these pipes, because the dialysate solution was constituted at each console. The pipes were sanitized by two strategies: (1) strong and monthly (hypochlorite concentration: 100 ppm) or (2) weak and weekly (5 ppm). Both strategies were easy because the sodium hypochlorite was simply added to the ROW tank. To estimate sanitization efficacy, endotoxin counts at the ROW tank outlet, the end of the pipe, and the pipe after the endotoxin-cutting filter in each console were measured monthly for six continuous months. These counts were compared between the two sanitization strategies. Results: The endotoxin counts at the ROW tank outlet and the end of the pipe were 0.004–0.017 and 0.012–0.081 EU/mL, respectively, in the strong and monthly strategy, and 0.001–0.003 and 0.001–0.005 EU/mL, respectively, in the weak and weekly strategy. The endotoxin counts at the pipe after the endotoxin-cutting filter were less than 0.001 EU/mL during the study period in both strategies. Conclusion: A weekly disinfection strategy was more effective than a monthly one, despite the lower hypochlorite concentration. The present study suggests that frequency is the most important factor in the disinfection of pipes in a dialysis room.

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Section: Discussionsupporting

confidence: 66%

An easy disinfection strategy for pipes connecting hemodialysis equipment

et al. 2020

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“…One method to produce and ensure the production of ultrapure dialysis fluid is to place an ultrafilter in the hydraulic path between the patient and the dialysis machine, as this filter will have the greatest impact to the final dialysis fluid solution prior to entrance into the dialyzer (Oliver et al, 1992;. Studies in the literature have revealed significant removal rates for ultrafilters in vitro, typically >99% for endotoxin (Oliver et al, 1992;Krautzig et al, 1996), with log reduction values >3 desirable (Tsuchida et al, 2009). Ultrafilters are commonly used in HDF, where two filters are typically used in series to guarantee sterile fluid production -manufacturers of ultrafilters state that sterility of substitution fluid is only guaranteed if the machine feed water falls within certain criteria (Penne et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

2011

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Water quality in conventional and home haemodialysis

2012

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Dialysis water can be contaminated by chemical and microbiological factors, all of which are potentially hazardous to patients on haemodialysis. The quality of dialysis water has seen incremental improvements over the years, with advances in water preparation, monitoring and disinfection methods, and high standards are now readily achievable in clinical practice. Advances in dialysis membrane technology have refocused attention on water quality and its potential role in the bioincompatibility of haemodialysis circuits and adverse patient outcomes. The role of ultrapure dialysate is increasingly being advocated, given its proposed clinical benefits and relative ease of production as a result of the widespread use of reverse osmosis and ultrafiltration. Many of the issues pertaining to water quality in hospital-based dialysis units are also pertinent to haemodialysis in the home. Furthermore, an increased awareness of the environmental and financial consequences of home haemodialysis has resulted in the development of automated and more efficient dialysis machines. These new machines have an increased emphasis on water conservation and recycling along with a decreased need for a complex infrastructure for water purification and maintenance.

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Current Situation of Endotoxin Retentive Filter

Cited by 7 publications

References 19 publications

An easy disinfection strategy for pipes connecting hemodialysis equipment

An easy disinfection strategy for pipes connecting hemodialysis equipment

Progress in Hemodialysis - From Emergent Biotechnology to Clinical Practice

Water quality in conventional and home haemodialysis

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