Hemodialysis - Chemical Dialysate Purity

Guideline Organization

Recommendation (Evidence Level)

Evidence

Comments

CARI-Australia
2000

Follow AAMI standards (Level III-IV)

Water quality for hemodialysis

For rationale, each time read below the guidelines.

Eliminate
- Particulate matter by 5 µm filter
- Calcium by water softener
- Chlorine or chloramines by charcoal
- Aluminum by reverse osmosis
- Fluoride by deionisation
- Others: less deleterious

CSN-Canada

EBPG-Europe
November 2002

Follow recommendations of European Pharmacopoeia (Level C)

Guideline IV.1 Water treatment system

KDOQI-US

UK-Guidelines
August 2002

Ready made concentrates are classified as medical devices and should display the CE mark. Concentrates that are manufactured ‘in house’ should meet the requirements of BS EN 13867: 2002 (Concentrates for haemodialysis and related therapies) and Europoean Pharmacopoeia 2003 (Solutions for haemodialysis). (Good practice)

Haemodialysis Guideline 3: Concentrates and water for haemodialysis