Abstract: Purpose To investigate the status of quality improvement of hemodialysis water and dialysate made in the past 3 years in Hemodialysis Centers of Beijing. Methods A formal questionnaire was prepared and distributed to hemodialysis centers in Beijing from 2002 to 2004. The questions were designed to acquire information on the frequency of monitor on hardness, electricity conductivity, chlorine, and bacteria culture of hemodialysis water, as well as on the management of dialysate. Two censuses on chemistry contaminations in hemodialysis water had been performed among 99 and 100 HD centers in 2003 and 2004, respectively. Also, a census on endotoxin contamination in dialysate was done in 2004. Results There were 88, 115 and 110 Hemodialysis Centers completed the questionnaires in 2002, 2003 and 2004, respectively. The participation rate was 95.7%, 95.8%, and 90.2%. In the past 3 years, the frequency of monitoring compliance to AMMI standard for the hardness，electricity conductivity, chlorine and bacteria culture of hemodialysis water has been improved significantly. All Hemodialysis Centers use biocarbonate dialysate with about 35.7% centers use dialysate solution directly. 98.2% centers can dissolve the dialysate concentrate properly. Individualized potassium and calcium concentration of dialysate can be prescribed in some centers. Overall non-compliance to the AAMI standard for chemistry was 18.6% and 4% in 2003 and 2004, respectively. The common chemistry contamination included calcium, nitrate, aluminum and chloramines in 2003, calcium and nitrate in 2004. The overall non-compliance to the AAMI standard for endotoxin was 28%. After improved the quality of water system, the final compliance became 100% for chemistry, and 98% for endotoxin. Conclusions In the past 3 years, the awareness of the significance of hemodialysis water and dialysate has been improved markedly among HD centers in Beijing. Nowadays, the chemistry and endotoxin contaminations of hemodialysis water and dialysate still exist in some centers, so we should pay attention to these problems and some routine measures for monitor the quality of hemodialysis water and dialysate should be taken by every HD center.

Key words: Hemdialysis water, Dialysate, Quality improvement