| Sumario: | The Ottawa Carleton Dialysis Clinic has undertaken the task to meet ISO 23500 standards for ultrapure water quality and dialysate. The reason for this is to perform online priming, as well as hemodiafiltration on our Fresenius 5008 hemodialysis machines. Online priming is the priming of the extracorporeal circuit with dialysate instead of saline. Hemodiafiltration is the injecting of dialysate directly into the extracorporeal circuit during dialysis either pre or post dialyzer. The criteria in meeting these standards involve having clean RO water, a hemodialysis machine capable of online priming and hemodiafiltration, a good disinfection process, and a good sampling process. We had to meet the challenges of finding a microbiology lab that would test low enough to meet ISO 23500 standards, finding a method and process to obtain samples from the Fresenius 5008 machine consisting of one sample of substitute and one sample of dialysate, as well as going through a validation phase of weekly testing for bacteria and endotoxins for a month. This required the testing of all our dialysis machines, as well as the reverse osmosis water treatment unit. By meeting ultrapure standards for water quality, we ensure a safer treatment for the patient, the treatment option of hemodiafiltration, as well as online priming to minimize saline bag use. This will result in more effective and efficient methods of dialysis.
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