Water purification is one of the most important aspects of safe and effective dialysis. There are many adverse clinical effects of inadequate or malfunctioning water purification. Water purification systems are designed to remove metals, electrolytes, and bacteria. Due to the great variation in water quality across the United States, the water purification needs of individual dialysis clinics may vary.
Water used for dialysis has strict requirements on the levels of chemical and biological contaminants allowed. Even so, since the introduction of high flux dialyzer membranes, the quality of conventional dialysate has become of great concern. It is well known that cytokine inducing substances in the dialysate can reverse filter across the high flux dialyzer membrane and into the patient's blood stream. This repetitive influx of biological contaminates may lead to chronic inflammation with patients having elevated levels of cytokines.