Bacteriological and Clinical Evaluation of Different Dialysate Delivery Systems

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Abstract
1964-74, 4 dialysate delivery systems were used. The first was central mixing of dialysate using tap water and a dialysate delivery line with "dead ends" resulting in stagnant dialysate. The 2nd was central mixing of dialysate with cold distilled water, otherwise equal to system 1. The 3rd was local mixing of dialysate with cold distilled water, delivered through a line with "dead ends" resulting in stagnant water. The 4th, local mixing of dialysate with distilled water, cooled to 25.degree. C just prior to use, reduced "dead ends" and monitored constant overflow to drain through the water supply line. The bacterial contamination of the 4 systems was examined and related to the clinical occurrence of pyrogenic and other reactions. An improvement was noted with the change from central to local mixing of dialysate (system 3) but complete sterility and virtual freedom from clinical reactions were first obtained in system 4. The use of sterile or near sterile dialysate is recommendable.