Double-stage reverse osmosis system for dialysis water yields lower colony count
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Key takeaways:
- AquaBplus achieved lower colony counts, calcium and sodium than dialysis machines without it.
- Fresenius clinics with and those without the system achieved acceptable water quality.
AUSTIN, Texas —The AquaBplus double-stage water purification system by Fresenius Medical Care uses reverse osmosis to yield lower colony count in dialysis water, according to a poster presented here.
“We conducted the analysis to assess the real-world water quality results of dialysis clinics using and not using AquaBplus reverse osmosis (RO) systems,” Linda H. Ficociello, DSc, the vice president of real-world evidence generation at Fresenius, told Healio about the poster presented at the National Kidney Foundation Spring Clinical Meetings. “The AquaBplus offers better water recovery, enhanced water quality monitoring and a chemical/heat disinfection with dead-free space design that theoretically provides improved microbial results. This retrospective analysis of more than 1,800 dialysis clinics provides information on the use of RO systems in real-world practice.”
In a cross-sectional study, researchers evaluated water quality among Fresenius Kidney Care hemodialysis clinics that installed the double-stage storage systems before 2021. Clinics included in the study had more than 10 hemodialysis machines and chairs that were using the AquaBplus double-stage RO (n=400) or non-AquaBplus ROs (n=1,410). Researchers collected water quality parameters and compared results between the two kinds of clinics using t-tests and chi-squared tests.
Analyses revealed the mean levels of colony counts, endotoxin and water analytes were less than the Association for the Advancement of Medical Instrumentation (AMMI) limits of 200 CFU/mL for the AquaBplus double-stage ROs or non-AquaBplus ROs (83.3% vs. 68.4% clinics with less than 2 CFU/mL).
“It is believed that optimal water quality for the production of dialysate leads to better outcomes in hemodialysis patients, thus dialysis clinics strive to achieve the best water quality possible,” Ficociello and colleagues wrote. “In this analysis, we found that all ROs that were used produced high-quality water and met all AAMI standards. However, we observed lower mean levels of endotoxin, sodium and calcium in clinics using AquaBplus. In addition, compared to non-AquaBplus clinics, a greater percentage of AquaBplus clinics were below the level of detection for colony counts, endotoxin and calcium.”
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Ficociello LH, et al. Poster 215. Presented at: National Kidney Foundation Spring Clinical Meetings; April 11-15, 2023; Austin, Texas.
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