User talk:Fahadhasanomer

This article discuss the importance of dialysis water testing while performing Hemodialysis and Hemodiafiltration.

In most of the dialysis centers substitution fluid is used to perform Hemodialfiltration and Hemofiltration. Dialysis machines producing substititution fluid with mixture of reverse osmosis water on-site and on-line allows large volume of volume to used for patients, upto 100 liters and more per dialysis session.

Substitutiobn fluid has a monograph in the 5th edition of the European Pharmacopoeia and is a drug. Substitution fluid as drug will have to meet standards for Endotoxin and bacterial Colony forming units to ensure the infused fluid is safe for performing HDF/HF. Prior to introduction of HDF ,conventional dialysis and on-line techniques, small volume where used and, hence, the allowed concentration of Endotoxin concentration was relatively high as 0.25 EU/ml. Using the drug defenition make substitution fluid interesting regarding endotoxins.

The limit set for allowed endotoxin for substitution is less than 0.015 EU per kg of body weight per hour and the process of testing the dialysis machines for endotoxin has to be established. Testing frequency followed by dialysis centers has to be streamlined.