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Nephrol Dial Transplant (2000) 15: 760-764
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Why and how to monitor bacterial contamination of dialysate?

Rafael Pérez-García and Pat O Cinio Rodríguez-Benítez

Servicio Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Introduction

The microbiological contamination of water concentrates and dialysate fluid is a problem which dates back to the distant past, but has recently gained again great actuality. Published data document that the bacteriological quality of the dialysate fluid plays a role in the ‘biocompatibility’ of haemodialysis (HD) [1,2]. Endotoxins in the dialysate fluid may enter the blood compartment and potently activate monocytes to produce pro-inflammatory cytokines [2]. Increased production of cytokines, mainly of IL-1, IL-6 and TNF-alpha, is thought to be causally related to several distinct acute and chronic problems of HD patients (Table 1Go) [3–5]. These cytokines trigger a series of acute phase reactants, and consequently, these patients exhibit a state of chronic microinflammation (Table 1Go) [6,7]. Some studies have found a relation between these acute phase reactants and mortality of patients on HD [6. . . [Full Text of this Article]

Factors influencing the risk of microbiological contamination of dialysis fluid

Relationship between bacterial contamination of the dialysate, endotoxin and cytokines

How can one adequately handle this problem?

Necessity to standardize control measures for detection of bacterial contamination of the dialysate

Conclusions

Acknowledgments

Notes

References


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