title: Water for haemodialysis and related therapies: recent standards and emerging issues.
abstract: Dialysis is a well-established and widely used procedure. For a number of years, the focus has been on ensuring that water used in the preparation of dialysis fluid meets the required chemical and microbiological quality and complies with national or international standards which have recently been updated. Continued vigilance is required, in particular when new chemicals such as silver-stabilized hydrogen peroxide and chlorine dioxide are used to prevent growth of Legionella bacteria in hospital water systems, since residues are harmful to patients receiving dialysis. To achieve the required quality, large volumes of water are processed, and a substantial portion is sent to waste via the municipal sewer systems with little attempt to reuse such water on site. In view of concern about global warming and climate change, there is a need to adopt a more environmentally conscious attitude requiring dialysis providers to focus on this aspect of water usage.
authors.affiliation: ICM Newcastle University, Newcastle upon Tyne, UK. nicholas.hoenich@ncl.ac.uk
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Hoenich
authors.forename: Robert
authors.initials: R
authors.lastname: Levin
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D000327:Adsorption; D001427:Bacterial Toxins / Q000009:adverse effects / Q000032:analysis; D017606:Chlorine Compounds / Q000009:adverse effects / Q000032:analysis; D003247:Conservation of Natural Resources; D015314:Dialysis Solutions / Q000592:standards; D004202:Disinfectants / Q000032:analysis; D004350:Drug Residues / Q000009:adverse effects / Q000032:analysis; D017743:Equipment Reuse; D017408:Guidelines as Topic; D015312:Hemodialysis Solutions / Q000592:standards*; D006801:Humans; D008452:Maximum Allowable Concentration; D008567:Membranes, Artificial; D010087:Oxides / Q000009:adverse effects / Q000032:analysis; D017582:Renal Replacement Therapy / Q000295:instrumentation / Q000379:methods; D014481:United States; D014865:Waste Disposal, Fluid / Q000379:methods; D014867:Water / Q000592:standards*; D014871:Water Microbiology; D014874:Water Pollutants, Chemical / Q000032:analysis; D014876:Water Pollution; D018508:Water Purification / Q000379:methods / Q000592:standards*; D014881:Water Supply / Q000592:standards
chemical_list: D001427:Bacterial Toxins; D017606:Chlorine Compounds; D015314:Dialysis Solutions; D004202:Disinfectants; D015312:Hemodialysis Solutions; D008567:Membranes, Artificial; D010087:Oxides; D014874:Water Pollutants, Chemical; D014867:Water; C025109:chlorine dioxide