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8 : Water-Transmissible Diseases and Hemodialysis

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Water-Transmissible Diseases and Hemodialysis, Page 1 of 2

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Abstract:

Among the renal replacement therapy modalities, hemodialysis represents 80% of the first treatment option and 60% of the final treatment of choice. In hemodialysis patients, infections are associated with considerable morbidity and mortality, ranking second as a cause of death, after cardiovascular diseases. Among infections acquired during hemodialysis sessions or associated with the dialysis devices, vascular access infections are responsible for almost 50% of all infections and is the most frequent agent. The presence of inorganic contaminants is associated with adverse outcomes in hemodialysis patients, including anemia, bone disease, and intradialytic nausea and vomiting. Exposure of hemodialysis patients to high levels of aluminum has also been associated with osteomalacia and progressive neurological deterioration. Pyrogenic reactions are episodes of rigors, shaking chills, fever, nausea, hypotension, and myalgia that occur after the start of the hemodialysis session. In a report from Thailand, nine patients were reported to have bloodstream infections due to . One patient died as a direct consequence of infection, and the remainder of the patients failed to respond to antibiotic therapy until the catheter was removed. These epidemiological mechanisms of water-transmissible infections in hemodialysis are summarized in this chapter. In hemodialysis patients, which represent the great majority of patients on renal substitutive therapy, infections are second only to cardiovascular diseases as the cause of death.

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8

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Figures

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Figure 1

Water treatment system in a Brazilian private hospital. From right to left are seem one sand filter, two softeners (iron-exchange filters), two charcoal (carbon) filters, and a set reverse-osmosis membranes.

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
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References

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Tables

Generic image for table
Table 1

Water contaminants frequently related to pyrogenic reactions during dialysis sessions

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
Generic image for table
Table 2

Basic components of water treatment stations for hemodialysis and potential drawbacks related to microorganism contamination

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
Generic image for table
Table 3

AAMI standards for treated water for hemodialysis sessions: maximum allowable chemical contaminant levels

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
Generic image for table
Table 4

Microbiologic standards for treated water and dialysis solution in different countries

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
Generic image for table
Table 5

Water contaminants and clinical consequences

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8
Generic image for table
Table 6

Epidemiology of water-transmissible diseases in hemodialysis

Citation: Camargo L, Neto M, Canziani M, Draibe S. 2001. Water-Transmissible Diseases and Hemodialysis, p 121-136. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch8

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