Biofilms in Hemodialysis

Abstract

During end stage renal disease the kidneys are not functioning properly and as such longer adequately remove waste from the blood stream. Hemodialysis is an invasive medical treatment were by the human body is routinely treated with large quantities of water as a mean to flush these waste from the body. As in all water systems this system is susceptible to biofilms. Advanced water purification system are used to purify the water entering these systems, however, bacteria have adapted to low nutrient niches such as this and a even a single bacteria may be sufficient to start biofilm development. These biofilms have been shown to develop throughout hemodialysis systems and have in some cases are suspected of causing out breaks for infection within dialysis centers. Additionally, biofilms produce endotoxins and other cytokines that can migrate across the dialysis membrane and cause an inflammatory response, which in time causes chronic inflammatory syndrome and further damages the body of what often very ill patients. Making the problem more challenging is the difficulty of removing biofilms from in-place water systems, as such as is used in clinical settings. For this reason a multi-step cleaning, descaling, and disinfection process in recommended for these system. With the ever-increasing numbers of patients on dialysis and other invasive medical treatment the need for understanding, treatment for and prevention of medical biofilms will only continue to expand.