A summary of the primary points follows: The microbiological quality of the dialysis fluid represents an independent determinant of the nutritional status, in addition to known factors such as dose of dialysis and biocompatibility of the dialyzer membrane. Ultrapure dialysis fluid adds to the cost of the dialytic treatment, but improves the nutritional status in long-term hemodialysis patients. Water quality needs to be routinely monitored to ensure that the potential risk to patients from chemical and bacterial contaminants is minimized; this requires the implementation of a quality approach. The layout and design of the water room and water system are key to producing and maintaining high-quality dialysis fluid. Routine monitoring and preventive maintenance of the water system will ensure that high-quality dialysis fluid is delivered.
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