Analysis of hemodialysis water quality from 2008 to 2016 in Minas Gerais, Brazil

Water quality requirements for hemodialysis are crucial for preventing health risks for renal patients. Theobjective of this study was to assess the quality of the water used for hemodialysis treatments in the state ofMinas Gerais. The analytical results for 25 parameters in 1056 hemodialysis water samples from 89 renaldialysis units were analyzed. Data were obtained through the Minas Gerais Hemodialysis Unit QualityMonitoring Programme between July 2008 and December 2016. The effects of the Programme on patienthealth protection were assessed by evaluating compliance with legal limits and the efficacy of implementinginspections from 2012. Considering the 1056 samples analyzed, 264 (25%) presented at least one parameterin disagreement with current legislation. Conductivity (9.8%), endotoxin (6.9%), fluoride (4.2%) andheterotrophic bacteria (2.2%) were the most critical parameters. Nevertheless, the concentrations of all theseparameters (except fluoride) decreased after implementing inspections. The average levels of 15 parametersdecreased throughout the study period. The annual percentage of non-compliance decreased from 44% in2008 to 23% in 2016. It was verified the relevance of the implementation of the Program in the prevention ofpossible disorders to the patients’ health, indicating the importance of its continuity.