Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jan-Feb;38(1):12-24.
doi: 10.1111/sdi.13174. Epub 2023 Sep 11.

Water and dialysis fluid purity for contemporary hemodialysis

Affiliations
Review

Water and dialysis fluid purity for contemporary hemodialysis

Bernard Canaud et al. Semin Dial. 2025 Jan-Feb.

Abstract

Introduction: The purity of water and dialysis fluids is of utmost importance in ensuring the safe and effective administration of hemodialysis treatment to patients with chronic kidney disease. It is crucial to enforce compliance with international standards for dialysis water and fluids, as this is mandatory in reducing chemical hazards, mitigating the adverse effects of bioincompatibility resulting from contaminated water and ultimately enhancing long-term patient outcomes.

Standards and risks: Within this comprehensive review, we highlight the presence of water contaminants and thoroughly assess the existing international standards for dialysis water and fluids, spanning from pure to ultrapure. Additionally, we delve into the fundamental components of water purification and present a comprehensive range of water treatment options, encompassing pre-treatment, primary treatment (reverse osmosis), and tertiary water treatment. Furthermore, we outline recommended monitoring and maintenance procedures, ensuring the consistent delivery of high-quality water and dialysis fluids at the point of care. WATER PURIFICATION AND MONITORING SUSTAINABILITY AND FUTURE CHALLENGES: Importantly, we raise concerns regarding the sustainability and conservation of water resources in hemodialysis treatment. It is imperative that these concerns be addressed in the future to avert the potential shortage of this essential resource.

Conclusion: In conclusion, the contemporary landscape of hemodialysis conditions has engendered an urgent necessity for advanced water treatment systems and optimized delivery of dialysis fluids. This review serves as a comprehensive update on the latest technological advancements aimed at meeting these critical demands. Dialysis water and fluids must adhere to increasingly stringent purity constraints, encompassing both biochemical and microbiological perspectives.

PubMed Disclaimer

Similar articles

Cited by

References

REFERENCES

    1. Collaboration GBDCKD. Global, regional, and national burden of chronic kidney disease, 1990‐2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2020;395(10225):709‐733. doi:10.1016/S0140‐6736(20)30045‐3
    1. Lim YJ, Sidor NA, Tonial NC, Che A, Urquhart BL. Uremic toxins in the progression of chronic kidney disease and cardiovascular disease: mechanisms and therapeutic targets. Toxins (Basel). 2021;13. doi:10.3390/toxins13020142
    1. Mathur M, D'Souza AV, Malhotra V, Agarwal D, Beniwal P. Uremic frost. Uremic Frost Clin Kidney J. 2014;7(4):418‐419. doi:10.1093/ckj/sfu057
    1. Meeus F, Kourilsky O, Guerin AP, Gaudry C, Marchais SJ, London GM. Pathophysiology of cardiovascular disease in hemodialysis patients. Kidney Int Suppl. 2000;76:S140‐S147. doi:10.1046/j.1523‐1755.2000.07618.x
    1. Pieniazek A, Bernasinska‐Slomczewska J, Gwozdzinski L. Uremic toxins and their relation with oxidative stress induced in patients with CKD. Int J Mol Sci. 2021;22(12):6196. doi:10.3390/ijms22126196

MeSH terms

LinkOut - more resources