Facts

Chemical Substances in Dialysis Water

In the US, dialysis water standards are set by the AAMI(Association for the Advancement of Medical Instrumentation).

Substances that must be removed from dialysis water:

  • Bacteria
  • Endotoxin
  • Nitrates
  • Calcium, Magnesium, Aluminum
  • Sodium & Potassium
  • Sulfate & Fluoride
  • Copper & Zinc
  • Heavy metals
  • Chloramines

 
Comparison of Drinking Water and Dialysis Water Standards

 

 

Contaminant

Potential Damages to the Human Body

Drinking Water Maximum Contaminant Level(MCL) under National Primary Drinking Water Regulations, mg/L

Dialysis Water: AAMI/ANSI Maximum Allowable Chemical Contaminant Levels, mg/L

Heavy Metals They are poisons and could build up in the body
  • Arsenic – 0.005
  • Barium – 0.1
  • Cadmium – 0.005
  • Chromium – 0.005
  • Lead – No MCL Action Level = 0.015 of Lead
  • Mercury – 0.002
  • Selenium – N/A
  • Arsenic – 0.005
  • Barium – 0.1
  • Cadmium – 0.001
  • Chromium – 0.014
  • Lead – 0.005
  • Mercury – 0.0002
  • Selenium – 0.09
Bacteria One-celled microbes that can cause disease.  Bacteria form bio-film (slime) that lets them cling to wet surfaces No Regulations 50 cfu/ml
Endotoxin Toxic parts of bacteria when bacteria die.  Can cause fever and chills in people on dialysis. No Regulations 1 Eu/ml
Nitrates Parts of some fertilizers keep human body from using oxygen. 10.0 2.0
Calcium and Magnesium “Hard water syndrome” Causes nausea, vomiting, headaches, skin flushing, week muscles, and blood pressure changes. No Regulations
  • Calcium – 2.0
  • Magnesium – 4.0
Sodium and Potassium Must have a minimum level No Regulations
  • Sodium – 70.0
  • Potassium – 8.0
Copper and Zinc These toxic metals could leach out of plumbing pipes or water cisterns.  Cause nausea, vomiting, liver damage, death of red blood cells, and other problems. No Regulations
  • Copper – 0.1
  • Zinc – 0.1
Chloramines Must be removed from dialysis water. No Regulations 0.1
Aluminum Can build up in the bones and brains of people on dialysis. No Regulations 0.01
Fluoride Help prevents tooth decay, but harmful to people on dialysis. 4.0 0.2