Abstract
Water suitable for drinking is unsuited for use in the preparation of haemodialysis fluid and undergoes additional treatment. The primary component of the additional treatment is reverse osmosis, which does not remove low-molecular-weight contaminants, and the water treatment system must contain carbon beds or filters to ensure effective removal of such contaminants. The recent article by Bek and colleagues highlights an unrecognised issue with respect to chemicals that may be added to the water within hospitals to ensure that the distribution network is free of pathogens (for example, Legionella, pseudomonas, and mycobacteria) and underlines the need for personnel responsible for dialysis in a renal or intensive care setting to be aware of any potential effects that disinfection of the hospital water treatment system may have on the product water used in the preparation of dialysis fluid. Such awareness requires communication and the sharing of information between clinical and facilities staff.
Highlights
The article by Bek and colleagues [1] in the previous issue of Critical Care raises an important and frequently unrecognised issue concerned with haemodialysis in a hospital setting
The design of the water treatment plants used in dialysis units is dependent upon the quality of the feed or raw water and the uses that the treated water is put to within the dialysis unit, the major components of treatment systems are pretreatment filtration, carbon filters that may be granular or in the form of a carbon block, and reverse osmosis units
The primary element for chemical contaminant removal is the reverse osmosis unit, which works by using pressure to force a solution through a membrane, retaining the solute on one side and allowing the pure solvent to pass to the other side
Summary
The article by Bek and colleagues [1] in the previous issue of Critical Care raises an important and frequently unrecognised issue concerned with haemodialysis in a hospital setting. To minimise risk from nosocomial infections, hospitals employ a range of preventive strategies to control the formation of biofilm, including the use of chemical agents such as silverstabilised hydrogen peroxide [4,5]. Hydrogen peroxide is an oxidising agent, which at concentrations used for disinfection is considered safe to drink, enabling it to be used in ‘live’ buildings, and is eco-friendly since it breaks down to water and oxygen.
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