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Vol. 22, No. 1, 2004
Issue release date: 2004
Section title: Paper
Blood Purif 2004;22:124–129
(DOI:10.1159/000074932)

When Good Water Goes Bad: How It Happens, Clinical Consequences and Possible Solutions

Lonnemann G.
Gemeinschaftspraxis Nephrology/Dialysis, Langenhagen, Germany

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 1/20/2004
Issue release date: 2004

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: http://www.karger.com/BPU

Abstract

Dialysis fluid produced by state-of-the-art water preparation and distribution is contaminated with gram-negative bacteria and cytokine-inducing substances (CIS) derived from these microorganisms. The presence of a biofilm increases the risk of continuous contamination of dialysis fluid. Depending on the type of dialyzer membrane (cellulosic vs. synthetic) and the mode of dialysis (low flux vs. high flux with backfiltration), CIS may penetrate intact dialyzer membranes, induce cytokine production in the patient’s blood and contribute to chronic inflammation associated with long-term hemodialysis therapy. Measures to improve the microbiological quality of dialysis fluid are: (1) the awareness of the problem and regular testing of dialysate samples using adequate methods; (2) disinfection of the entire water preparation and distribution system on a regular basis, replacement of biofilm-containing tubings, and (3) installation of ultrafilters in the dialysate circuit in particular when high-flux hemodialysis modalities are performed.

© 2004 S. Karger AG, Basel


  

Author Contacts

Gerhard Lonnemann, MD
Gemeinschaftspraxis Nephrology/Dialysis
Eickenhof 15
DE–30851 Langenhagen (Germany)
Tel. +49 511 786560, Fax +49 511 7865625, E-Mail GLonnemann@t-online.de

  

Article Information

Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 21

  

Publication Details

Blood Purification
Founded 1983; edited by K. Schaefer (1983–1988)
Official Journal of the International Society of Blood Purification and the Vascular Access Society (VAS)

Vol. 22, No. 1, Year 2004 (Cover Date: 2004)

Journal Editor: K.M.L. Leunissen, Maastricht
ISSN: 0253–5068 (print), 1421–9735 (Online)

For additional information: http://www.karger.com/bpu


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 1/20/2004
Issue release date: 2004

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: http://www.karger.com/BPU


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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