The Impact of Reverse Osmosis Water on the Prognosis of Dialysis Patients at Universitas Airlangga Hospital, Indonesia

Hemodialysis RO Water Endotoxin Dialysis Patients

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June 30, 2025

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Mortality after introducing hemodialysis was high at the beginning of the project. St Mary’s hospital has started the cooperation to improve Reverse Osmosis (RO) water, by changing the hemodialysis circuit to the hygienic piping route, verifying bacteriological tests with adequate sampling, and introducing endotoxin filter. The above interventions were only implemented in ward 1 but not in ward 6. Totally, 415 patients who had hemodialysis from March 2018 to December 2023 were enrolled. 181 patients were in Ward 1 and 234 were in ward 6. These patients were followed until they dropped off. Biochemical data from 68 patients and culture and endotoxin data from RO water were analyzed at the available period of the month.  The outcome of ward 1 became better than that of ward 6 and the improvement of prognosis was more obvious under 55 patients. The viable bacteria data in RO water showed the eminent fluctuations in Ward 1. Biochemical data were not significantly different, except for the anemia level. Endotoxin level was drastically improved and have reached National standards. The improvement of RO water was attributed to the better prognosis and its effect was more obvious in younger patients. Further study is needed to clarify factors, such as renal function, complications of patients.