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

Hilinski, Ellen Gameiro; Almodóvar, Adriana Aparecida Buzzo; Silva, Fernando Pontes de Lima e; Pinto, Terezinha de Jesus Andreoli; Bugno, Adriana

doi:10.1590/s2175-97902019000417835

Cited by 6 publications

(7 citation statements)

References 28 publications

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“…In this research, around 30% of the samples of post-RO water and 13% of dialysate samples presented unconforming parameters regarding the THB recommended. Comparatively, studies in the southeastern region of Brazil, which assessed a larger number of hemodialysis units, a more extended period, and a greater number of samples, indicated higher non-compliance rates, ranging from 27% to 63% (Hilinski et al, 2020). In contrast, other investigations, also encompassing a broader sampling, reported lower rates, ranging from 5% to 8% (Almodovar et al, 2018).…”

Section: Bacteriological Parametersmentioning

confidence: 81%

“…Despite established guidelines, studies conducted in Brazil reveal dissatisfaction levels regarding certain parameters of water quality intended for hemodialysis, such as high levels of heterotrophic bacteria, elevated concentrations of endotoxins (Almodovar et al, 2018;Hilinski et al, 2020;de Jesus et al, 2022), and the significant presence of aluminum (de Jesus et al, 2022). Additionally, some studies report the presence of fungi in these waters, posing potential risks to the health of hemodialysis patients (Montanari et al, 2018;Oliveira et al, 2018;Anversa et al, 2021;Calumby et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

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Physical-chemical and microbiological characterization of water destined to hemodialysis

Gomes,

Campos,

Sant’ana

et al. 2024

Rev. ambiente água

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This research evaluated the physical-chemical and microbiological parameters of water and dialysate in four distinct hemodialysis units located in the southeast region of Brazil. The physical-chemical parameters evaluated were pH, electric conductivity, turbidity, alkalinity, free chlorine, nitrate, fluoride, chloride, sulfate, sodium, potassium, calcium, and magnesium ion concentrations. Microcystin was also quantified. The microbiological parameters evaluated were the detection of total coliform, total heterotrophic bacteria count (THB), and the isolation and identification of microorganisms in pre-reverse osmosis treatment and post-reverse osmosis treatment water samples and dialysate. The nitrate, fluoride and THB levels found in the water samples may present risk to the patient under hemodialysis treatment. Microcystin was detected in one of the potable water samples. Microorganisms were identified throughout the hemodialysis of the entire water treatment system, with Ralstonia sp. being the most frequent. The presence of emergent pathogenic bacteria highlighted in this study highlights the necessity of microbiological monitoring of water destined for hemodialysis. Keywords: dialysate, hemodialysis, water treatment.

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Section: Bacteriological Parametersmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Physical-chemical and microbiological characterization of water destined to hemodialysis

Gomes,

Campos,

Sant’ana

et al. 2024

Rev. ambiente água

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“…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).…”

Section: Discussionmentioning

confidence: 99%

Water treatment for hemodialysis in Baghdad medical city, Iraq

Humudat

Al‐Naseri

Imran

2022

Environmental Quality Mgmt

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Water quality for dialysis fluid is an important consideration for dialysis patients. As a result, strict monitoring of water quality is required to avoid complications and ensure the safety and health of patients. The current study aimed to determine the water quality used in hemodialysis treatment centers. Twenty water samples were collected and analyzed from three hospitals in Baghdad's medical city over four seasons. Counts of bacteria and chemical contaminants were determined in raw and dialysis water from each of four dialysis centers. After collecting samples, bacteriological and chemical analyses were performed in the laboratory. Results show that the quality of dialysis water fluctuates, making it unacceptable when compared to international standards. Bacterial counts were above the maximum value of 100 CFU/ml in 50% of the samples tested. Chemical analysis showed that the dialysis water quality suffers from elevated free chlorine concentrations in some dialysis centers. Also, there were no significant differences between the measured parameters in the dialysis water at four treatment centers during the study period at p < 0.05. Hemodialysis centers require constant monitoring, maintenance, and the development of water treatment systems to ensure optimum water quality. Additional disinfection is essential in order to prevent bacterial growth and biofilm formation.

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“… 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.…”

Section: Introductionmentioning

confidence: 99%

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

Naderi

Attar

Mohammadi

2022

Environ�Health�Insights

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Background: One of the most common diseases in the world is kidney failure, which can lead to the death of patients. Hemodialysis is a treatment for patients whose kidneys are failing. The water used to perform dialysis must be healthy, safe, and clean. This study aimed to investigate the concentration of heavy metals in hemodialysis water in one of the Hospitals in Iran and compare it with European Pharmacopeia (EPH) and Association for the Advancement of Medical Instrumentation (AAMI) standards. Methods: The present study is a descriptive-analytical study conducted on the inlet water of hemodialysis machines in hospital. The samples were collected for 3 months from June to September 2021, Which was examined in terms of free residual chlorine, electrical conductivity, pH, and calcium, magnesium, sodium, aluminum, zinc, copper, and lead concentration. Metals concentration in hemodialysis water was measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) technique. Results: The average value of parameters such as electrical conductivity, pH, residual free chlorine, sodium, calcium, magnesium, zinc, copper and lead in the hemodialysis water was less than the AAMI and EPH standards limits. There was a significant difference at the 95% confidence level with the standard limits, but the aluminum concentration was higher than the standard limits. Also, by examining the medical files of dialysis patients, the most observed problems were anemia and bone diseases, which are probably caused by exposure to high concentrations of aluminum in hemodialysis water. Conclusion: In present study the aluminum concentration is higher than the standard limits. Considering that the higher aluminum concentration can cause diseases such as anemia, bone diseases, nervous deterioration, and death in hemodialysis patients, therefore, it is recommended to continuously evaluate and monitor the quality of hemodialysis water and the performance of its treatment system.

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

Cited by 6 publications

References 28 publications

Physical-chemical and microbiological characterization of water destined to hemodialysis

Physical-chemical and microbiological characterization of water destined to hemodialysis

Water treatment for hemodialysis in Baghdad medical city, Iraq

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

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