If dialysis water tests indicate contamination, what is the appropriate action?

• A. Continue dialysis and test again later.
• B. Ignore contamination if symptoms are mild.
• C. Halt use of water/dialysate and investigate/correct water quality before resuming.
• D. Increase dialysate flow to dilute contaminants.

Answer: (C)

When dialysis water tests show contamination, the immediate priority is patient safety by stopping the use of the water and dialysate and addressing the water quality problem before resuming. Dialysate comes into contact with blood during treatment, so any microbial, endotoxin, or chemical contamination in the water can cause serious reactions, inflammation, or harm to the patient. Even if symptoms seem mild, the risk persists because repeated exposure across sessions can lead to worse outcomes.

The correct action is to halt use of the water and dialysate, investigate the water quality issue, and implement corrective measures—such as repairing or replacing faulty components, performing system sanitization, flushing the lines, and re-testing to confirm that all parameters meet established standards—before restarting dialysis. Only after the water meets required safety limits should therapy resume, with ongoing monitoring for any adverse signs.

Continuing dialysis without addressing the contamination or simply increasing dialysate flow does not eliminate the underlying risk and can expose patients to serious harm.