Abstract: 【Abstract】Objective Dialysis water compliant with the safety standards is fundamental to the daily work in hemodialysis centers. This study aimed to explore the management methods to limit the endotoxin content in dialysis water using the changes of endotoxin content data from hemodialysis centers as the reference. Method The data of endotoxin content in dialysis water from March 2019 to February 2020 in 21 blood purification centers in Shanghai were recruited and analyzed. Result Endotoxin content in dialysis water increased in the spring and summer in a part of the samples. Endotoxin content >0.25 EU/ml accounted for 0.57% and endotoxin content of 0.03～0.25 EU/ml accounted for 7.34% in the water samples detected in the spring, while endotoxin content >0.25 EU/ml accounted for 1.13% and endotoxin content of 0.03～0.25 EU/ml accounted for 3.39% in the water samples detected in the summer. The difference of endotoxin content was statistically significant between the water samples detected in the summer and those detected in the winter (F=11.392, P=0.001). Conclusion To reduce the adverse reactions relating to hemodialysis and to promoting the hemodialysis quality, care must be focused on rigorous control of every steps in production and transportation of dialysis water, standardized processes of sampling, daily maintenance and management of the reverse osmosis machines, and thorough disinfection of the water treatment and pipe system.

Key words: Dialysis water, Endotoxin, Sampling, Maintenance and management, Disinfection