Water Treatment for Hemodialysis: Keeping Patients Safe

All nurses with any responsibility for hemodialysis need to know and understand the clinical ramifications of water treatment and dialysate preparation. Although some hemodialysis programs may have full-time technical staff who operate and test the water treatment and dialysate preparation systems, many programs rely on nursing staff for the day-to-day operation and testing of these systems. It is critical for all staff members to work together to keep patients safe. This article details reasons safe water and dialysate are critical for patients on hemodialysis and reviews components of water treatment systems, dialysate concentrate preparation, and monitoring and testing necessary to assure that both water and dialysate are safe for patient use. Integrated hemodialysis systems (i.e., those that combine water treatment and dialysate preparation and delivery in an individual machine "package") are also described.