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Water for Hemodialysis

Chemical and microbial components that can be found in drinking water may have the potential to produce significant negative effects in patients undergoing hemodialysis. It is, therefore, necessary to subject the water to further treatment to reduce these components to acceptable levels. The Water for Hemodialysis monograph in USP provides bacterial and chemical tests that are required to ensure patient safety.

Additional testing is recommended as follows:

In addition to the above, the water for Hemodialysis must also meet microbial requirement as follows:

Microbial Parameter

Limit

Total aerobic microbial count (TAMC)

100 cfu/mL

Endotoxin

1 USP Endotoxin Unit/mL

Further, the the dialysate itself is required to be free of contaminants as per USP.

Contaminant

Limit

 Calcium

2 (0.1 mEq/L)

 Magnesium

4 (0.3 mEq/L)

 Potassium

8 (0.2 mEq/L)

 Sodium

70 (3.0 mEq/L)

Other contaminants

 Antimony

0.006

 Arsenic

0.005

 Barium

0.1

 Beryllium

0.0004

 Cadmium

0.001

 Chromium

0.014

  

 Mercury

0.0002

 Selenium

0.09

 Silver

0.005

  

 Thallium

0.002

The USP limits are in line with the water standards for hemodialysis established by the American National Standards Institute/Association for the Advancement of Medical Instrumentation (ANSI/AAMI).

CLL’s Water Related services:

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