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Water Treatment in the Home Hemodialysis Setting: Use of Recirculators Decrease Bacteria and Endotoxin Contamination
Author(s) -
Bender W,
Torres M,
Kechker E,
PitnerKeller K,
Galan C
Publication year - 2003
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1046/j.1492-7535.2003.01257.x
Subject(s) - overheating (electricity) , home hemodialysis , medicine , water quality , hemodialysis , water treatment , environmental science , waste management , contamination , environmental engineering , surgery , engineering , ecology , electrical engineering , biology
Water for home hemodialysis is treated using carbon filtration and a series of deionization (DI) tanks. These systems are practical and insure quality product water. The main drawback is susceptibility to bacterial contamination and growth. In an effort to control bacterial growth and endotoxin production in our training rooms and patient homes, our DI systems are being equipped with recirculators consisting of a pump and a flow switch. The pump maintains water in constant recirculation through the DI tanks and lines. This pump was selected to prevent overheating of the water in the system during recirculation, thus helping to prevent bacterial growth. The flow switch is a safety device that stops the pump if the flow rate drops below a preset value while also preventing the pump from overheating should the system develop a leak. The plumbing of this system prevents untreated water from bypassing the DI tanks, while the water quality remains monitored at the product port. We began using recirculators in March of this year in our training rooms. Our results have improved from 7 sets of cultures requiring an action, per AAMI standards, in 8 patient months prior to recirculator installation, to the need to re‐sanitize one system, one time since recircultor installation during the ensuing 11 patient months. We currently have 3 recirculator systems (out of 8 DI home systems) in patient homes. One patient on rural water had AAMI action levels with 8 sets of cultures since January, 2002, prior to recirculator installation. He has experienced no action level needs since installation in early August. Aside from home installation problems with the initial patient, recircultors have resulted in no AAMI action levels over the past 6 patient months.