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Microbial contamination is characterized not only by the presence of bacteria, but also by high concentrations of biologically active by-products. They are potentially able to cross ultrafiltration and dialysis membranes and stimulate immunocompetent blood cells to synthesize cytokines. In turn, cytokine induction causes acute symptoms and has been incriminated in the long-term complications of haemodialysis patients. Infusion of large volumes of substitution fluids following ultrafiltration of microbially contaminated dialysis fluids may place patients on on-line therapies at particular risk.

nephrology, dialysis, transplantation/nephrology dialysis transplantation

Can sterile and pyrogen‐free on‐line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on‐line haemodiafiltration