A dialysis patient is exposed per treatment to an amount of water equivalent to what the average person drinks over the course of their entire life. For most, standard tap water is safe to drink. However, to hemodialysis patients, it can be harmful if contaminants are not filtered out prior to treatment. And with climbing dialysis costs placing increasingly larger burdens on hospitals and patients, it’s more important than ever that critical pre-reverse osmosis (RO) filtration practices help lessen the burden of disease.
Providing the highest quality water is essential for safe and effective hemodialysis therapy.
Fortunately, water treatment through RO systems not only ensures that patients receive safe, clean water while undergoing hemodialysis, it also reduces energy use which means lower operating costs for hospitals and clinics. Maintaining safe levels of water purity certainly isn’t natural or easy as water is by nature impure, capable of dissolving and absorbing more naturally occurring and man-made substances and impurities than any other liquid.
Contaminants such as chlorine and chloramines are extremely toxic to hemodialysis patients, and some chemicals can accumulate causing long-term health problems. Because compromised kidneys are unable to remove these contaminants from the body, it is essential that the water used for dialysis meet the highest AAMI standards. Due to the chemicals added to make it safe to drink, tap water fails to meet these standards. This is because tap water also contains chemicals such as aluminum sulfate, fluoride and ozone which can be very harmful to dialysis patients. Therefore, a highly effective RO system is needed, although equally important is the preliminary filtration it receives via a pre-treatment system. Pre-treatment systems not only remove dangerous contaminants, they lessen the strain on RO membranes and help to identify leaks or drops in pressure.
While quality pre-treatment systems are necessary for ensuring that the water used for dialysis meets the necessary AAMI standards, additionally the devices used for pre-treatment can further reduce the operational costs of RO machines by making them more effective and efficient, which in turn reduces RO machine downtime and minimizes skipped treatments. Most RO machines can be relied upon to remove as much as 99 percent of contaminants, but certain elements can still penetrate RO membranes which can be harmful to the RO system as well as the patients. In short, pre-treatment systems do the extra work of removing contaminants that the RO machines cannot in order to achieve ultrapure water.
Unfortunately, mortality rates are high among dialysis patients. Approximately one-quarter of patients in dialysis programs die within a year of initiating therapy. However, over the past two decades, a reduction in mortality has been achieved. The factors responsible are not yet fully understood but they could include improved management of comorbidities, better prevention of dialysis-related complications such as infection, and better care of patients prior to the initiation of dialysis programs.
Still, millions of people die of kidney failure each year, often without the proper care as the costs of dialysis therapies are high and rising. Dialysis patients bear a high burden of disease and a low health-related quality of life. Research cites symptoms such as fatigue, insomnia, cramps, depression and anxiety as contributing to inadequate outcomes for dialysis patients. This is why patients, regulators and health-care systems increasingly demand better dialysis care, and an important first step is proper pre-treatment of RO dialysis rinse water which not only positively affects RO therapies and reduces the wear on reverse osmosis machines, it helps control and perhaps even lower healthcare costs.