Abstract: 【Abstract】 Objective To investigate endotoxin (ET) in hemdialysis water and dialysate used in the hemodialysis centers in Shanghai, and the factors relating to the ET contamination. Methods Specimens of hemdialysis water and dialysate were collected from 36 hemodialysis centers in Shanghai during Nov. 2010 to Oct. 2012. ET contamination in hemdialysis water and dialysate were evaluated. Results (a) Of the 4438 samples obtained, 3790 (85.40%) contained ET＜0.1 EU/ml, 482 (10.86%) samples contained ET 0.1-0.5 EU/ml, and 166 (3.75%) contained ET＞0.5EU/ml. (b) In the 36 hemodialysis centers, 14 centers used double osmosis water treatment system and 22 centers used single osmosis water treatment system. In water samples from single osmosis system and double osmosis system, ET <0.1 EU/ml was found in 76.93% and 90.32% samples, respectively, and ET 0.1-0.5 EU/ml was detected in 15.48% and 6.93% samples, respectively. These differences were statistically significant. (c) The average ET level was significantly higher in August than in other months of the year. Conclusion The quality of hemdialysis water and dialysate was consistent with the national standards in most hemodialysis centers in Shanghai. Double osmosis system is better than single osmosis systems in treatment of water for hemodialysis. Seasonal influence also determined ET contamination in hemodialysis water.

Key words: Endotoxin, Hemdialysis water, Dialysate, Hemodialysis