Standard on Microbiological Management of Fluids for Hemodialysis and Related Therapies by the Japanese Society for Dialysis Therapy 2008

The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high‐performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.

[1]  K. Iseki,et al.  Bacteriological Qualities of Dialysis Fluid in Japan as of 31 December 2006 , 2008, Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy.

[2]  R. Schindler,et al.  Short bacterial DNA fragments: detection in dialysate and induction of cytokines. , 2004, Journal of the American Society of Nephrology : JASN.

[3]  M. Nangaku,et al.  Ultrapure dialysate decreases plasma pentosidine, a marker of "carbonyl stress". , 2004, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[4]  H. Kawanishi,et al.  Experience with the JMS Fully Automated Dialysis Machine , 2003, ASAIO journal.

[5]  R. Fischer,et al.  Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients. , 2002, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[6]  I. Ichikawa,et al.  Embryogenesis of the congenital anomalies of the kidney and the urinary tract. , 2002, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[7]  P. Stenvinkel.  Inflammatory and Atherosclerotic Interactions in the Depleted Uremic Patient , 2000, Blood Purification.

[8]  A. Bergner,et al.  Dialysate related cytokine induction and response to recombinant human erythropoietin in haemodialysis patients. , 2000, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[9]  S. Schlotter,et al.  Novel online infusate-assisted dialysis system performs microbiologically safely. , 2000, Artificial organs.

[10]  I. Ledebo.  On-line hemodiafiltration: technique and therapy. , 1999, Advances in renal replacement therapy.

[11]  浩世 森井,et al.  ガンブロ社AK100-Ultraのための透析液安全基準・施設基準について , 1998 .

[12]  M. Nakamoto,et al.  Dialysate and substitution fluid quality for on‐line haemodiafiltration and haemofiltration , 1997 .

[13]  Y. Berland,et al.  Using Ultrapure Water in Hemodialysis Delays Carpal Tunnel Syndrome , 1991, The International journal of artificial organs.

[14]  K. Farrington,et al.  Identical decline of residual renal function in high-flux biocompatible hemodialysis and CAPD. , 2002, Kidney international.

[15]  I Ledebo,et al.  Defining the microbiological quality of dialysis fluid. , 1999, Artificial organs.

[16]  Suhail Ahmad,et al.  Dialysate for hemodialysis , 1996 .

[17]  S. Yamagami.  Standard decision reports of dialysis fluid safety. Examining subcommittee of evaluating criterion for water quality and pyrogen filter. , 1995 .

[18]  L. Henderson,et al.  Hemodialysis Hypotension: The Interleukin Hypothesis , 1983 .