Contaminant | Component of the water treatment system used for removal |
Chemical contaminants with documented toxicity in hemodialysis patients | |
Aluminum | Reverse osmosis (60 to 99% removal) |
Copper | Reverse osmosis (96 to 99% removal) |
Fluoride | Reverse osmosis (80 to 99% removal) |
Lead | Reverse osmosis (95 to 99% removal) |
Nitrate | Reverse osmosis (90 to 95% removal) |
Sulfate | Reverse osmosis (96 to 99% removal) |
Zinc | Reverse osmosis (96 to 99% removal) |
Disinfectants added to water either municipally or locally with potential or documented toxicity in hemodialysis patients | |
Chlorine and monochloramine | Carbon filtration* |
Chlorine dioxide | |
Hydrogen peroxide | |
Silver-stabilized peroxide | |
Peracetic acid | |
Sodium hypochlorite (bleach) | |
Trace elements regulated in drinking water with potential toxicity in hemodialysis patients | |
Antimony | Reverse osmosis (<90% removal) |
Arsenic | Reverse osmosis (50 to 99% removal) |
Barium | Reverse osmosis (99% removal) |
Beryllium | Reverse osmosis (>90% removal) |
Cadmium | Reverse osmosis (93 to 99% removal) |
Chromium | Reverse osmosis (85 to 99% removal) |
Mercury | Reverse osmosis (94 to 98% removal) |
Selenium¶ | Reverse osmosis (99% removal) |
Silver¶ | Reverse osmosis (93 to 97% removal) |
Thallium | Reverse osmosis (>90% removal) |
Substances included in the hemodialysis fluid prescription | |
Calcium | Softener, reverse osmosis |
Magnesium | Softener, reverse osmosis |
Potassium | Reverse osmosis |
Sodium | Reverse osmosis |
Microbial contaminants | |
Bacteria | Reverse osmosis, ultrafiltration, ultraviolet radiationΔ |
Endotoxin | Reverse osmosis, ultrafiltration, ultraviolet radiationΔ |
Contaminants with uncertain toxicity | |
Per- and polyfluoroalkyl substances (PFAS) | Anion exchange resin (90 to 99% removal) |
Reverse osmosis (93 to 99% removal) | |
Carbon filtration (89 to 98% removal) | |
Bisphenol A (BPA)◊ | Reverse osmosis, nanofiltration |
Microplastics | Reverse osmosis, nanofiltration |
* Effectiveness depends upon the disinfectant and the presence of other substances that might compete for binding or reaction sites.
¶ Selenium and chromium levels in dialysis water are set at the "no-transfer" level.
Δ Used in conjunction with a bacterial and endotoxin-retentive filter.
◊ Also known as 2,2-Bis(4-hydroxyphenyl)propane.Do you want to add Medilib to your home screen?