ISO 23500 Series: Ensuring Quality of Fluids for Hemodialysis and Related Therapies

Treu, Denny; Maltais, Jo-Ann B.

doi:10.2345/0899-8205-53.2.147

Cited by 3 publications

(1 citation statement)

References 1 publication

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“…Water, and dialysis fluids made from it, need to conform to quality standards established by different regulatory bodies to ensure patient safety [ 97 , 105 ]. It is not the intent of this paper to compare the recommended limits of the various standardization authorities and the reader is referred to Ward et al.…”

Section: Transport Of Toxic Substances Into the Blood Compartment During Haemodialysismentioning

confidence: 99%

Clinical relevance of abstruse transport phenomena in haemodialysis

Bowry¹,

Kırçelli

Mooppil³

et al. 2021

Clinical Kidney Journal

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Haemodialysis (HD) utilizes the bidirectional properties of semipermeable membranes to remove uraemic toxins from blood while simultaneously replenishing electrolytes and buffers to correct metabolic acidosis. However, the nonspecific size-dependent transport across membranes also means that certain useful plasma constituents may be removed from the patient (together with uraemic toxins), or toxic compounds, e.g. endotoxin fragments, may accompany electrolytes and buffers of the dialysis fluids into blood and elicit severe biological reactions. We describe the mechanisms and implications of these undesirable transport processes that are inherent to all HD therapies and propose approaches to mitigate the effects of such transport. We focus particularly on two undesirable events that are considered to adversely affect HD therapy and possibly impact patient outcomes. Firstly, we describe how loss of albumin (and other essential substances) can occur while striving to eliminate larger uraemic toxins during HD and why hypoalbuminemia is a clinical condition to contend with. Secondly, we describe the origins and mode of transport of biologically active substances (from dialysis fluids with bacterial contamination) into the blood compartment and biological reactions they elicit. Endotoxin fragments activate various proinflammatory pathways to increase the underlying inflammation associated with chronic kidney disease. Both phenomena involve the physical as well as chemical properties of membranes that must be selected judiciously to balance the benefits with potential risks patients may encounter, in both the short and long term.

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Section: Transport Of Toxic Substances Into the Blood Compartment During Haemodialysismentioning

confidence: 99%

Clinical relevance of abstruse transport phenomena in haemodialysis

Bowry¹,

Kırçelli

Mooppil³

et al. 2021

Clinical Kidney Journal

View full text Add to dashboard Cite

show abstract

Magnetic solid phase extraction followed by in-situ derivatization with core–shell structured magnetic graphene oxide nanocomposite for the accurate quantification of free testosterone and free androstenedione in human serum

Zhang

Zhou

et al. 2022

Journal of Chromatography B

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Sodium Hypochlorite is Effective against Biofilms in Dialysis Equipment

et al. 2021

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To test the efficacy of chemical disinfectants against bacterial biofilms in hemodialysis equipment, a Center for Disease Control and Prevention (CDC)-Biofilm Reactor was used to create biofilms. Methylobacterium radiotolerance was isolated from the hemodialysis fluid and used as the test organism. We examined the efficacy of sodium hypochlorite (NaOCl) in elimination of planktonic cells compared to that in the case of biofilms. Planktonic bacteria were completely eliminated at 50 parts per million (ppm) of NaOCl, which is the lowest concentration for clinical use. The viable cell count in the biofilm reached its minimum value around a logarithmic reduction value (LRV) of 6, when the concentration was raised to 1000 ppm and the reaction time was extended by 1 hour or more. Furthermore, at 200 ppm, the LRV was elevated depending on the time. And the LRV while maintaining static conditions for 6 hours at 200 ppm was similar to that of short time at 1000 ppm. These results suggest that NaOCl has sufficient bactericidal activity even for biofilms at a practical concentration and reaction time, and that the CDC-Biofilm Reactor is an effective tool for finding useful disinfection conditions.

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ISO 23500 Series: Ensuring Quality of Fluids for Hemodialysis and Related Therapies

Cited by 3 publications

References 1 publication

Clinical relevance of abstruse transport phenomena in haemodialysis

Clinical relevance of abstruse transport phenomena in haemodialysis

Magnetic solid phase extraction followed by in-situ derivatization with core–shell structured magnetic graphene oxide nanocomposite for the accurate quantification of free testosterone and free androstenedione in human serum

Sodium Hypochlorite is Effective against Biofilms in Dialysis Equipment

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