Research of endotoxins in hemodialysis water

Abstract

Introduction: Chronic kidney disease is characterized by loss of kidney function leading to a physiological and biological functional imbalance. One of the treatments necessary for the chronic renal patient is hemodialysis. Water quality is critical to reducing patient risk. Resolution RDC n. 11, of March 13th, 2014, from Brazilian Health Regulatory Agency (Anvisa) establishesd the search for endotoxins, as venous contamination by endotoxins may cause various problems in the patients’ health. Objective: To identify endotoxins in purified water for hemodialysis. Method: This is a Quantitative Descriptive Cross-sectional Study to verify the presence of endotoxins in 126 water samples collected at two points (post-reverse osmosis and reuse room) at six renal substitution therapy clinics, by the State Sanitary Surveillance, and analyzed in the LACEN, in Campo Grande, MS, in 2016. Results: Of the 68 water samples collected after the reverse osmosis process, three (4.41%), and of the 58 samples collected in the reuse room, six (10.52%) presented endotoxin results above the amount allowed by the legislation (0.25 EU\mL). Conclusions: Results indicate membrane involvement of the reverse osmosis process, and, or presence of biofilm in the pipes, and inefficiency of the cleaning process of the reservoir, pipes, and machines disinfection process.