Physical-chemical and microbiological characterization of water destined to hemodialysis

Abstract

This research evaluated the physical-chemical and microbiological parameters of water and dialysate in four distinct hemodialysis units located in the southeast region of Brazil. The physical-chemical parameters evaluated were pH, electric conductivity, turbidity, alkalinity, free chlorine, nitrate, fluoride, chloride, sulfate, sodium, potassium, calcium, and magnesium ion concentrations. Microcystin was also quantified. The microbiological parameters evaluated were the detection of total coliform, total heterotrophic bacteria count (THB), and the isolation and identification of microorganisms in pre-reverse osmosis treatment and post-reverse osmosis treatment water samples and dialysate. The nitrate, fluoride and THB levels found in the water samples may present risk to the patient under hemodialysis treatment. Microcystin was detected in one of the potable water samples. Microorganisms were identified throughout the hemodialysis of the entire water treatment system, with Ralstonia sp. being the most frequent. The presence of emergent pathogenic bacteria highlighted in this study highlights the necessity of microbiological monitoring of water destined for hemodialysis.