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논문분류	춘계학술대회 초록집
제목	Water Treatment for Hemodialysis
저자	EUN JU JEONG
출판정보	2017; 2017(1):
키워드
초록	During hemodialysis the amount of water that contacts the patient’s blood is more than 25 times the amount consumed by drinking. In a dialysis system the dialysis membrane cannot select ions to be absorbed or rejected, and these ions pass via diffusion. So water purity is very important and special water treatment is necessary. Nurses may not routinely service the water treatment system, they are responsible for understanding all of the clinical ramifications of water treatment. Water contamination can lead to anemia, alterations in blood pressure and acid-base balance, neurological issues, bone disease, and patients may suffer acute or chronic problems from exposure to substandard dialysate. Water for hemodialysis is used to treat the following method: Filtration, Activated carbon filter (adsorption), Water softeners, Reverse osmosis (RO), Deionization (DI), Ultraviolet (UV) light exposure The major change in the 2011 update of the AAMI standards was that include recommendations of lower bacterial and endotoxin levels and different culturing methods. The 2009 AAMI standards require that the bacteria levels in water used for HD shall not exceed 100 colony forming units/ml, the action level will be 50% of the maximum allowable level. Culture media should be tryptone glucose extract agar (TGEA), Reasoners 2A (R2A). Samples shall be incubated at 17° to 23° C for 168 hours. endotoxins in the water used for HD purposes shall not exceed 0.25 EU/mL (endotoxin units/mL), and action must be taken when the level exceeds 0.125 EU/mL. By understanding water treatment system operation, dialysate purity issues, and the nuances of patient reactions, nephrology nurses can protect patients from unsafe water and dialysate and contribute immensely to long-term positive outcomes for patients.
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