Bacteriological qualities of dialysis fluid in Japan as of 31 December 2006.

The Japanese Society for Dialysis Therapy (JSDT) collected the data from 3488 dialysis facilities about the status of bacteriological qualities and quality controls for dialysis fluid as of 31 December 2006. The data included the endotoxin (ET) levels, bacterial counts and usage of ET retentive filters (ETRFs). It was found that ET level measurements were performed in 2873 facilities (82.4%). The JSDT standard for ET level in dialysis fluid (<0.050 EU/mL) was achieved in 89.0%, and an ET level less than 0.001 EU/mL was achieved in 29.8%; however, bacterial counts were examined in only 1049 facilities (34.1%). The JSDT standard for the bacterial cell count in dialysis fluid (<100 cfu/mL) was achieved in 96.9%, and a count of 0.1 cfu/mL, which guarantees ultra-pure dialysis fluid, was achieved in 48.4%. ETRFs were installed in 78.5% of all facilities and in 53.4% of all dialysis machines. Although the JSDT standard is the most stringent in the world, the compliance rate was excellent. Bacteriological water qualities of dialysis fluid are extremely high in most Japanese dialysis facilities and this might have a close relationship to the high dialysis patient survival rate in Japan.