Rapid implementation of an emergency on-site CKRT dialysate production system during the COVID-19 pandemic

BMC Nephrology

Table 1 Testing for composition and microbiologic contamination of locally produced CKRT dialysate

	Trial Phase (July 2020)		Implementation Phase (January 2022)
Fluid Incubation Period (hours)^a	0	0	24	48
Approximate Testing Interval (hours)^a	24	48	48	72
Sodium (mEq/L)	140	141	142	143
Potassium (mEq/L)^b	2.3	2.3	3.0	3.0
Chloride (mEq/L)	110	110	110	110
Calcium (mEq/L)	2.5	2.5	2.6	2.6
Bicarbonate (mEq/L)	34	33
Magnesium (mEq/L)	1.0	1.0
Glucose (mg/dL)	110	109
Colony Count (CFU/mL)	< 2		< 2	2
Endotoxin Level (EU/mL)	< 0.010		< 0.010	< 0.010

Abbreviations: CFU colony forming units, EU endotoxin units
Conversion factors for units: glucose in mg/dL to μmol/L, × 0.05551; calcium or magnesium in mEq/L to mmol/L, × 0.5
^aDuring the trial phase, the fluid was immediately collected after production and two samples were shipped at room temperature to the reference lab, one tested upon arrival approximately 24 h after collection and a second stored locally for 24 h at the lab and then tested approximately 48 h after collection; in contrast, in the implementation phase, dialysate bags were stored locally at room temperature for 24 h and 48 h, and then samples were collected from the bags and shipped to the reference lab and tested upon arrival approximately 24 h later
^bWe used 2K hemodialysis concentrate in the testing but used 3K concentrate in the implementation phase

ISSN: 1471-2369