The role of water in dialysis: why does it need to be more than "clean"?

The importance of maintaining a high quality water system cannot be stressed enough. Many reports have been published that link chronic inflammation to microbial and endotoxin contamination of water used for dialysate. While the use of ultra filters on individual dialysis machines will reduce the bacterial and endotoxin levels in dialysate, the efficacy of the ultrafilters will be decreased if the levels of bacterial and endotoxin contamination are too high. The individual components of a water system must be treated as a whole and all policies and procedures pertaining to the water system must be strictly adhered to in order to maintain the water system at peak condition.