透析液清浄化ガイドライン Ver. 2.01€析液清浄化ガイドライン Ver. 2.01 2014年...

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透析液清浄化ガイドライン Ver. 2.02014年 3 11 (公社)日本臨床工学技士会 透析液等安全委員会

Transcript of 透析液清浄化ガイドライン Ver. 2.01€析液清浄化ガイドライン Ver. 2.01 2014年...

  • Ver. 2.0

    201 3 11

  • 1

    11 50

    22

    AB

    HDF/HF

    HDF/HF

    HDF/HF

    5121

    MF

    512

    51

    AB

    HDF/HF

  • 2

    Reverse Osmosis : RO

    5352 TOC

    RO

    UF

    RO

    BA

    BB

    B

    A

    A

    ET Retentive filter(ETRF)

    HDF/HF

    Annex

  • 3

    2004 ISO/AAMI

    2009ISO 116635

    139586)1395972672282011ISO 235009

    20101HDF/HF

    4

    2012403051

    HDF2

    HDF/HF

    ISO

    32

    17710

  • 4

    http://www.mhlw.go.jp/topics/bukyoku/kenkou/suido/kijun/kijunc

    hi.html

    11 50H23.4.1

    1 100/mL

    2

    0.003mg/L

    0.0005mg/L

    5 0.01mg/L

    6 0.01mg/L

    7 0.01mg/L

    0.05mg/L

    9 0.01mg/L

    10 10mg/L

    11 0.8mg/L

    12 1.0mg/L

    13 0.002mg/L

    14 1,4- 0.05mg/L

    15 -1,2--1,2-

    214 0.04mg/L

    16 0.02mg/L

    17 0.01mg/L

    18 0.01mg/L

    19 0.01mg/L

    20 0.6 mg/L

    21 0.02mg/L

    22 0.06mg/L

    http://www.mhlw.go.jp/topics/bukyoku/kenkou/suido/kijun/kijunchi.htmlhttp://www.mhlw.go.jp/topics/bukyoku/kenkou/suido/kijun/kijunchi.html

  • 5

    23 0.04mg/L

    2 0.1mg/L

    25 0.01mg/L

    26 0.1mg/L

    27 0.2mg/L

    28 0.03mg/L

    29 0.09mg/L

    30 0.08mg/L

    31 1.0mg/L

    32 0.2mg/L

    33 0.3mg/L

    34 1.0mg/L

    35 200mg/L

    36 0.05mg/L

    37 200mg/L

    38 () 300mg/L

    39 500mg/L

    40 0.2mg/L

    41 0.00001mg/L

    42 2- 0.00001mg/L

    43 0.02mg/L

    44 0.005mg/L

    45 (TOC) mg/L

    46 pH 5.88.6

    47

    48

    49 5

    50 2

    ISO

    139597)ISO 235009)1

  • 6

    22

    No mg/L

    1 2 (0.1mEq/L)

    2 (0.3mEq/L)

    3 8 (0.2mEq/L)

    70 (3.0mEq/L)

    5 0.006

    6 0.005

    7 0.10

    8 0.000

    9 0.001

    10 0.01

    11 0.005

    12 0.0002

    13 0.09

    1 0.005

    15 0.01

    16 0.10

    1 0.10

    1 0.20

    2.0

    100

    0.002

    0.10

    Annex

  • 7

    0.0EU/mL 0.001 EU/mL

    1 CFU/mL 0.CFU/mL

    L100mL

    AB

    0.00EU/mL

    1 CFU/mL 0.CFU/mL

    L100mL

    2 HDF/HF

    0.001EU/mL

    1 CFU/mL

    L100mL

    0.00EU/mL

    1 CFU/mL 0.CFU/mL

    L100mL

    0.001EU/mL

    0.1 CFU/L

    0L100mL

    0.001EU/mL

    0.1 CFU/L 1 CFU/L

    0L100mL

  • 8

    HDF/HF

    0.001EU/mL

    1 CFU/mL

    L100mL

    HDF/HF

    0.001EU/mL

    1 CFU/mLnot detected

    0L100mL

    RO

    AB

    A 40 B 20

    MF

    Reasoners Agar No2

    20

    RA

    0.05100L

  • 9

    5121

    512 MF

    MF m

    11

    512

    HDF/HF

    12)13)

    1

    RO

    RORO

    500mL/min

  • 10

    AB

    Annex

    500mL/min

    500mL/min

    2ETRF

    HDF/HF

    500mL/min

    22ETRF

  • 11

    1

    RO

    25 m

    P

    RO)

  • 12

    CaMgAl Na

    Na

    NaNa

    NaCl

    Na

    0.1mg/L

    FRP

  • 13

    DPDP

    Reverse Osmosis : RO

    RO RO

    RO

    RO

    5351

    RO 5075

    /100

    5075

  • 14

    5352 Total Organic CarbonTOC

    RO

    TOC

    0.5mg/L500ppb

    TOC

    535

    RO

    25

    535 RO

    RO

    RO

    RO RO

    3 RO

    RO 56

    RO

    DNA 260nm

    253.7nm

  • 15

    7,0008,000

    RO

    A

    UF

    ROET100ROUF

    RO

    UF

    UF

    UF

    UFET

    ROET

    UF

    ROUF

    3 RO

    ROICU

  • 16

    1/1/

    RO

    RO

    BBA

    A

    BA

    B

    AA

    B

    B

    BB

    B

    ETB

    100ppm

    B

  • 17

    B

    B

    BA

    B

    A

    A

    A

    ET

    A

    A

    pH

    5

  • 18

    ET Retentive filterETRF

    ETETRF

    ETRF

    ETRF

    ETRF

    ET

    ET

  • 19

    0.020.1

    Na 30 RO

    HDF/HF

    HDF JIS T

    3250 4.5.2 HDF

  • 20

    1) .

    .2004.126-132

    2) Clinical Engineering 6

    2005 Vol No.5.548-556

    1) Henderson LW,Koch KM,Dinarello CA,et all Hemodialysis

    hypotensionThe interleukin hypothesis,Blood purification 1: 3-8,

    1983

    2) VOL.30.NO,1

    13-20, 2002

    3) VOL.30.NO,7

    427-429, 2002

    4) Schindler R,Beck W,Deppisch R,et al:Short bacterial DNA

    fragments:detection in dialysate and induction of cytokinesJ Am Soc

    Nephrol 15(12):3207-3214,2004

    5) ISO 11663Quality of dialysis fluid for haemodialysis and related

    therapies.

    First edition 2009-04-15

    6) ISO 13958Concentrates for haemodialysis and related

    therapies .Second edition 2009-04-15

    7) ISO 13959Water for haemodialysis and related therapies. Second

    edition 2009-04-15

    8) ISO 26722Water treatment equipment for haemodialysis

    applications and related therapies. First edition 2009-04-15

    9) ISO 23500Guidance for the preparation and quality management

    of fluids for haemodialysis and related therapies. First edition

    2011-05-15

    10) 101 2005

    11)

    42(1):85-90,2009

    12) 33:

    , 2009

    13) RO

    40(12):1051-1056,2007

  • 21

    14) 2011 (ETRF)

    44(9):977~990,2011

    Annex

    ISO

    1) http://www.iso.org/iso/store.htm

    2) http://www.webstore.jsa.or.jp/webstore/ISO/html/jp/menu.htm?lang=jp

    3 RO

    RO

    RO 510

    100

    4RO

    ET

    RO 100

    0.15ET

    O

    1 EU ET

    ET

    5

    ET

    6

    137 134 131

  • 22

    90%

    7

    512 MF

    L

    MF