'Clean dialysate' requires not only lower levels of endotoxin but also sterility of dilution water.
Clean dialysate should be used in dialysis with a high-flux dialysis membrane to avoid contamination of endotoxin into blood circuits. For this purpose, we should not only clean up the end stream dialysate by endotoxin-cut filters, but also prevent bacterial growth in dilution water lines. Delivery lines of the prepared dialysate from a central dialysate-supplying machine are sterilized in all dialysis facilities, but those of the dilution water in cases of using personal dialysis machines are not sterilized in most facilities in Japan. In our dialysis department, the endotoxin level in the dilution water lines decreased to <50 EU/l in 3 weeks by sterilization with a low concentration of sodium hypochlorite (30-100 ppm) once a week from the peak level of >1,000 EU/l just after the start of sterilization.
Shinoda
Toshio
T
Social Insurance Chuo General Hospital, Tokyo, Japan. shinodatmd@par.odn.ne.jp
D015314:Dialysis Solutions / Q000592:standards*; D004731:Endotoxins / Q000032:analysis*; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D013242:Sterilization / Q000379:methods*; D014867:Water / Q000592:standards
D015314:Dialysis Solutions; D004731:Endotoxins; D014867:Water