Pretreatment and Preparation of City Water for Hemodialysis

Abstract

In the early years of chronic hemodialysis, water used for dialysis was rarely treated. Because average patient survival was short, there was a general unawareness of acute or chronic complications from exposure to tap water contaminants. Since the late 1960’s, however, nephrologists have become increasingly aware of both acute and chronic problems resulting from exposure to untreated water. Contaminants present in both tap water and concentrate used for dialysate preparation, may enter patient’s blood stream across the dialyzer membrane in large amounts because of the large volume of fluid to which the patient is exposed during treatment (140 to 240 1). Trace amounts of contaminants especially the metals, present in dialysate may result in considerable into the blood stream (1). Such accumulation is worsened as a result of a longer biological half-life because of the absence of urinary excretion. There is evidence that pediatric patients may be more susceptible to trace metal-induced complications than adults.