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ABSTRACT: The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.
Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 05/2009; 13(2):161-6. · 1.39 Impact Factor
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ABSTRACT: There has been remarkable medical and technological progress in Japanese dialysis therapy where more than 270 thousand patients had been treated with dialysis by the end of 2007. Clinical engineering technologists have played an important role not only in the safety treatment but also in the technological development of dialysis therapy. It is very important to supply pure dialysis fluid for both the efficacy and the safety of hemodialysis in which high permeable dialysis membranes are used. The Japanese Society for Dialysis Therapy recently issued the standard for bacterial management of fluids for hemodialysis and related therapies according to the International Organization for Standardization (ISO)/DIS 23500. In order to achieve the standard, the management of dialysis water treatment is important as well as the role of clinical engineering technologists in daily dialysis practice. Purification is defined as no contamination by chemical substances and/or microorganisms and its components. The purification consists of the design and the system structure of the water treatment equipment and dialysis fluid-supplying equipment, and the operation and management of the equipment. The guideline aims to show the minimum standard and the management method of the water treatment system and dialysis fluid-supplying equipment in order to perform hemodialysis safely. They should outline safer dialysis by the management of purification of dialysis fluid.
Blood Purification 01/2009; 27 Suppl 1:41-9. · 2.10 Impact Factor
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ABSTRACT: Whereas the main measure of dialysis fluid purity is endotoxin (ET) activity in Japan, it is the viability count in Western countries. Because of this difference, little information is available concerning dialysis fluid purity determined in terms of viability count in Japan. Under these circumstances a fact-finding investigation was planned and conducted concerning dialysis fluid purity to demonstrate the effectiveness of dialysis fluid purification measures. 93 medical institutions are equipped with the central dialysis fluid delivery system (CDDS) unique to Japan. Almost all medical institutions surveyed have achieved the purification level of ultrapure dialysis fluid after ETRF, but the methods of ETRF use and management widely vary with each institution so that early validation of the methods of evaluation of ET inhibition and system management is in urgent need. It is also important that simple universal microbial monitoring and purification procedures be diffused far and wide as suggested by the Purification Guidelines proposed by us.
Blood Purification 01/2009; 27 Suppl 1:64-9. · 2.10 Impact Factor
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Nippon rinsho. Japanese journal of clinical medicine 06/2004; 62 Suppl 5:203-8.
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ABSTRACT: If a natural disaster or other event causes damage that makes dialysis therapy impossible, what steps should be taken? Many actions will be required, including disaster recovery activities in the affected area as well as the performance of dialysis at substitute dialysis facilities outside the affected area. The Japanese Association of Dialysis Physicians (JADP), in collaboration with the Japan Association for Clinical Engineering Technologists (JACET), operates an "information sharing system" that will be essential when carrying out post-disaster activities. This system consists of a website and mailing lists on the Internet, and it has been used in 11 disasters so far.The JADP is an organization of doctors engaged in dialysis therapy. This association conducts investigation and research, education, and crisis management for dialysis therapy. The JACET is an organization that aims to enhance scientific knowledge and skills and to improve capabilities. This association also pursues improvement of the reliability of medical care involving life support systems and other medical equipment.
Biomedical Instrumentation & Technology 43(1):70-2.
