the water in your home might be safe to drink, and in general it is extremely
safe, but it is not safe to use for hemodialysis treatments. For this
reason, people who use home dialysis systems must have a water purification
system either built into their home dialysis equipment or in addition to
a home dialysis equipment so that the water they use for their dialysis
treatments is ultra pure.
who sell water purification systems are regulated by the Food and Drug
Administration (FDA). Water systems along with dialysis machines, are
mandated as Class II medical devices by the FDA. Class II devices require
diligent tracking of critical components and a complaint investigation
system in place. Class I devices include loosely regulated items such
as tongue depressors and band-aids, while Class III stringently regulates
devices like high-flux hemodialyzers and implantable pace makers and requires
tracking of all parts (even nuts and bolts).
are many opportunities for water to pick up environmental substances starting
when rain drops fall down to earth. Gases such as carbon dioxide can be
picked up by the rain, dissolve and make acid rain. Once water seeps down
into the earth, it can pick up numerous minerals including calcium from
limestone, metals such as lead and copper and even poisons such as arsenic.
There are man-made impurities that can contaminate the water such as pesticides
and fertilizers. Well water often contains a large amount of salt, while
water from reservoirs usually harbors bacteria, viruses and algae. And
finally, city water suppliers add chemicals to water to destroy bacteria,
fluorides to prevent tooth decay, and aluminum to make the water clear.
Unlike your drinking water that contains chloramines for disinfection
purposes, dialysis centers must remove this before treating its patients.
Dialysis centers and hospitals are notified before a water system converts
to chloramine. Like chlorine, chloramine residuals need to be removed
from water that is used for dialysis machines. As part of their standard
test procedures, technicians check for total chlorine residuals (due to
chloramine) to ensure the residual is zero. Some machines may need modifications
depending on the method of chlorine removal that is currently used. A
change in the disinfectant used to treat the water should not impact or
require any change in the normal operation of dialysis machines.
does the water I use for my dialysis treatments have to be ultra pure?
The thin, hair-like threads inside your dialyzer are hollow. The walls
of these fibers are made of a semipermeable material which acts like a
filter. During your dialysis treatment, your blood flows inside these
hollow fibers, while the outside of the fibers is bathed in dialysate.
Dialysate is a cleansing solution which is a mixture of water and chemicals
that pulls the wastes and extra fluid through the fibers and out of your
blood. However, because the fibers are semipermeable, if the water used
to make the dialysate is not completely pure, impurities from the water
in the dialysate can get into your blood. Many of these impurities can
cause you serious harm. If anything less than ultra pure water is used
during your dialysis treatment, a variety of things could happen:
- Too much calcium or magnesium can cause nausea, vomiting, muscle weakness,
severe headaches, skin flushing and low or high blood pressure.
- Metals can cause a variety of symptoms including liver damage, inflammation
of the pancreas, destruction of red blood cells, seizures, brain damage
and even death.
- Pesticides and fertilizers can cause headaches, dizziness, convulsions
and heart and liver damage.
- The chemicals added to destroy bacteria will destroy red blood cells
if they enter the blood stream
- Bacteria and endotoxin can cause infections and fever.
- Overexposure to fluoride can cause abnormal hardening of bones, as well
as nausea and vomiting, muscle twitching, low blood pressure and seizures.
tap water into ultra pure water for dialysis treatments is essential to
protect dialysis patients from harm or injury. A dialysis center’s biomedical
technicians will ensure that your dialysis equipment functions properly
and are well trained to operate the system and perform required safety
tests. Contact your health care team to assist you with questions or concerns
you may have.