Changing paradigms of renal replacement therapy in chronic kidney disease patients: ultrapure dialysis fluid and high-efficiency hemodiafiltration for all?

Ultrapurity of dialysis fluid is important for the biocompatibility of renal replacement therapy systems. Penne and collaborators have assessed the microbiological quality of water and dialysis fluid in dialysis facilities. No side effects were noted in 97 patients who received 11,258 online hemodiafiltration sessions. This study confirms that ultrapure water and dialysis fluid may be easily produced and used for online hemodiafiltration.