Sakuma Koji, Uchiumi Nobuko, Sato Sumihiko, Aida Nobuhiko, Ishimatsu Taketo, Igoshi Tadaaki, Kodama Yoshihiro, Hotta Hiroyuki
Sato Clinic Hemodialysis Center, 2138-4 Wakamatsu-cho, Wakaba-ku, Chiba, 264-0021, Japan.
J Artif Organs. 2010 Sep;13(3):145-50. doi: 10.1007/s10047-010-0505-0. Epub 2010 Jun 1.
We applied the heat citric acid disinfection method in the main part of the central dialysis fluid delivery system (MPCDDS), which consists of a multiple-patient dialysis fluid supply unit, dialysis console units, and dialysis fluid piping. This disinfection method has been used for single-patient dialysis machines, but this is the first trial in the MPCDDS. We examined, by points of safety and disinfection effect, whether this disinfection method is comparable to conventional disinfection methods in Japan. The conventional disinfection method is a combination of two disinfectants, sodium hypochlorite and acetic acid, used separately for protein removal and decalcification. Consequently, total microbial counts and endotoxin concentrations fully satisfied the microbiological requirements for standard dialysis fluid of ISO 11663. From our results and discussion, this heat citric acid disinfection method is proved to be safe and reliable for MPCDDS. However, to satisfy the microbiological requirements for ultrapure dialysis fluid, further consideration for this method in MPCDDS including the reverse osmosis device composition and piping is necessary.
我们在中央透析液输送系统的主要部分（MPCDDS）应用了热柠檬酸消毒法，该系统由多患者透析液供应单元、透析控制台单元和透析液管道组成。这种消毒方法已用于单患者透析机，但这是在MPCDDS中的首次试验。我们从安全性和消毒效果方面考察了这种消毒方法是否可与日本的传统消毒方法相媲美。传统消毒方法是两种消毒剂（次氯酸钠和乙酸）的组合，分别用于去除蛋白质和脱钙。因此，总微生物计数和内毒素浓度完全符合ISO 11663标准透析液的微生物学要求。从我们的结果和讨论来看，这种热柠檬酸消毒法被证明对MPCDDS是安全可靠的。然而，为了满足超纯透析液的微生物学要求，有必要在包括反渗透装置组成和管道的MPCDDS中对该方法作进一步考虑。
