{"id":9932,"date":"2025-10-28T14:51:34","date_gmt":"2025-10-28T17:51:34","guid":{"rendered":"https:\/\/grupoep.com.br\/agua-de-hemodialise\/"},"modified":"2026-04-07T09:28:15","modified_gmt":"2026-04-07T12:28:15","slug":"agua-de-hemodialise","status":"publish","type":"post","link":"https:\/\/grupoep.com.br\/en\/artigos\/agua-de-hemodialise\/","title":{"rendered":"Hemodialysis Water: Water that sustains life"},"content":{"rendered":"\t\t
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According to the Brazilian Society of Nephrology (SBN), Brazil has approximately 172,000 patients undergoing renal replacement therapies, mainly hemodialysis, most of whom are treated by the Unified Health System (SUS) [1].<\/span><\/p>

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What is Hemodialysis?<\/b><\/h3>

Hemodialysis is a procedure that replaces the function of compromised kidneys. In this therapy, a machine filters the patient’s blood, removing toxic waste and excess fluids [2]. During the process, the blood is taken from the patient by vascular means and propelled with the aid of a pump to the dialysis filter (dialyzer). It is at this point that the blood is exposed to the dialysis solution (dialysate) through a semi-permeable membrane, returning it clean to the patient’s body [2]. <\/span><\/p>

Water is an essential component during hemodialysis, being used in large volumes and requiring high purity. Dialysate flow ranges from 500 to 800 mL\/min, resulting in 120 to 192 liters of water per session [3]. Considering that patients perform, on average, three weekly sessions of approximately 4 hours each, each patient comes into contact with 300 to 600 liters of water. In addition, there is exposure to potential chemical and biological contaminants, which makes ensuring quality water essential for patient safety [2, 3]. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

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Curiosities about hemodialysis<\/b><\/h3>\n

The episode known as the “Hemodialysis Tragedy” in Caruaru, PE in 2016 highlighted the risk of water contamination and reinforced the need for strict regulation of this type of treatment [4]. One of the main standards governing hemodialysis is RDC No. 11 of March 13, 2014, which establishes Good Operating Practice Requirements for Dialysis Services, including microbiological parameters (endotoxins, total coliforms and heterotrophic bacteria counts) and limits for metals and ions such as fluoride, nitrate and sulfate [5]. <\/span><\/p>\n

Microbiological control of hemodialysis water is essential to avoid serious inflammatory reactions in patients. Analyses should be carried out monthly, after the reverse osmosis system and in the distribution loop. Bacterial endotoxins, toxins released by the walls of bacteria even after their death, and the count of heterotrophic bacteria are critical parameters. RDC 11\/2014 defines that counts \u2265 100 CFU\/mL of heterotrophic bacteria or endotoxin levels > 0.25 EU\/mL indicate an immediate alert, requiring a review of the water purification system [5]. Any case of fever or suspected infection in patients should prompt an immediate water quality check. <\/span><\/p>\n

In addition to the microbiological risk, the presence of metals and excess minerals in hemodialysis water represent a significant chemical risk. The accumulation of these substances further overloads already compromised kidneys [6, 7]. <\/span><\/p>\n