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At the recently held ART meeting I gave a talk on current and future standards for water and dialysis fluid. There is a proposal to reduce the permitted levels of electrolytes in the water used for the preparation of dialysis fluid. (See Table below)
Sodium 70 (3,0 mmol/L) reduced to 50 (2,2 mmol/L)
Potassium 8 (0,2 mmol/L) reduced to 2 (0,05 mmol/L)
Magnesium 4 (0,15 mmol/L) reduced to 1 (0,04 mmol/L)
Calcium 2 (0,05 mmol/L) no change proposed
The thinking behind the proposals is as follows:
Sodium: This revision ensures that the contribution of dialysis water to the final dialysis fluid remains minimal, specifically well below 2.5% of the typical sodium concentration in the dialysis fluid.
Potassium: This revision ensures that the contribution of dialysis water to the final dialysis fluid remains minimal, i.e., ≤ 5% of the typical potassium concentration in the dialysis fluid.
Magnesium: This revision ensures that the contribution of dialysis water to the final dialysis fluid remains minimal, i.e., ≤ 5% of the typical potassium concentration in the dialysis fluid In addition, the revision corrects a chemical inconsistency in the previous limit: in natural water, calcium typically exceeds magnesium in concentration, with a Ca:Mg ratio of approximately 3:1. Therefore, the previous limit of 4 mg/l for magnesium compared to 2 mg/l for calcium did not reflect the typical balance found in water hardness and lacked chemical justification.
I would appreciate the views of technologists concerning this proposal in order to establish if the suggested changes result in any issues , namely if you look at your incoming water to the water treatment system are the suggested values achievable on a routine basis?
Many thanks
Nh
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