A new central supply system as alternative source for bicarbonate dialysate.

ABSTRACT

Bicarbonate dialysis is mandatory for high efficiency treatment. In most cases bicarbonate is delivered either as prepacked powder or as a stable liquid concentrate in 6-10 I plastic containers. With a newly designed central supply system (CSS) using 800 I tanks of custom-made sterile and pyrogen free concentrates, we investigated the risk of bacterial contamination of dialysate in a 30-bed dialysis unit. During three months, samples of reverse osmosis (RO) water, concentrates and dialysate were taken every two weeks. Colony forming units (CFU) were counted after 48 h incubation. Further samples were taken during nine months of continuous use of the CSS without further intermittent disinfection. None of the samples had greater than 10/ml CFU. Pseudomonas, corynebacteria and enterobacter were the predominant species. In summary, this CSS proved reliable in providing bacteriologically safe bicarbonate dialysate as defined by international standards (CFU less than 200/ml). It significantly reduces costs, workload and environmental pollution by plastic waste.