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Nephrol Dial Transplant (1999) 14: 2579-2582
© 1999 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Chloramine, a sneaky contaminant of dialysate

Rafael Pérez-García and Patrocino Rodríguez-Benítez

Jefe Clínico Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Correspondence and offprint requests to: R. Pérez-García, Jefe Clínico Nefrología, Hospital General Universitario Gregorio Marañón, c/Dr. Esquerdo 46, E-28007 Madrid, Spain.

What are chloramines?

Chloramines, derived from chlorine and ammonium, are added to water as disinfectants and may contaminate dialysis fluid and enter the blood of dialysis patients causing haemolytic anaemia.

Depending on the number of chlorine atoms that bind to nitrogen in exchange for hydrogen, monochloramines, dichloramines or trichloramines are formed [1]. The type of chloramine formed depends on the molar proportion of chlorine and nitrogen and the pH of the solution. If the pH is greater than 6 and if the molar proportion of chlorine is less than 5, monochloramines preferentially are formed. Since these conditions are present in the majority of city water supplies, monochloramines are most frequently encountered, and these have the least oxidative potential.

For what purpose are chloramines used?

Amongst the methods to render city water suitable for drinking, chlorination is the most important one. One of the methods of chlorination entails the formation of chloramine when ammonium and chlorine are added . . . [Full Text of this Article]

How can chloramines be eliminated from water?

Acceptable concentrations of chloramines

What are the toxic effects of chloramine and the clinical presentation?

Conclusions

Acknowledgments

Notes

References


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