Management Of Water Quality In Some Dialysis Centres In Giza Governorate Hospitals, Egypt

Dialysis patients are exposed to more than 40 times more water per week than healthy individuals drink. Therefore, this study aims at how to prevent risk factors that may be in the dialysis water by water quality monitoring to develop a Dialysis Water Safety Plan (DWSP) appropriate for the water source quality and conditions of each dialysis unit to prevent morbidity and mortality associated with dialysis water contaminants. 204 samples were taken from hospitals drinking water before treatment and 342 samples after treatment from 24 dialysis units from 17 hospitals that are fed from surface or underground sources in Giza from April 2020 to March 2021 monthly. Chemical and microbiological analysis were performed according to the American standard methods for the examination of water and wastewater. Visiting the treatment units once a month to monitor any change or inefficiency in any part of the unit. The findings showed that drinking water results were applicable to Egyptian limits except 2.45% for ammonia, iron (9.3%), manganese (6.86%), Total Coliform (2.9%), Escherichia coli (1.96%) and heterotrophic plate count in 1.96%. Hemodialysis water were not applicable for residual chlorine (0.87%), ammonia (1.46%), nitrites (2.6%), sodium(0.58%), potassium (0.29%), calcium (2.05%), magnesium (1.46%), total dissolved solids (1.46%), aluminium (0.58%). Total Coliform (2.6%), and E.coli in (1.46%), Pseudomonas (5.3%) and Streptococcus in (2.6%), and heterotrophic plate count (4.1%). But after the corrective actions according to DWSP, all samples became applicable. Thus, it is clear that DWSP should be implemented by developing an understanding of the system and its ability to provide safe dialysis water