Hemodialysis Consumes the World's Plenty of Water Water: the Analysis of Water Discharged from Reverse Osmosis and Usefulness

Year 2023, Volume: 18 Issue: 3, 134 - 143, 30.09.2023

Sultani Akbaş Yeşil , Zelal Adıbelli , İlhan Asana , Hafize Kurt , Soner Duman , Ender Hür

https://doi.org/10.47565/ndthdt.2023.76

Abstract

Introduction: In the hemodialysis water system, "raw water" refers to mains or artesian water, while "pure water" denotes the purified water used for diluting concentrated hemodialysis solutions. There is often confusion between "rejected water," which is discharged from the reverse osmosis device and usually discarded into the sewer, and hemodialysis wastewater, which comes into contact with a patient's blood post-treatment. Our study aims to assess the quality of this rejected water and explore ways to repurpose it rather than disposing of it.

Materials and Methods: Approval was obtained from the Manisa Celal Bayar University Ethics Committee for the study titled "Hemodialysis Consumes the World's Water." The fundamental principle of the reverse osmosis system is to filter water from harmful and contaminating substances by passing it through a semi-permeable membrane under high pressure. In our study, we conducted microbiological and chemical analyses of the water discharged from the reverse osmosis water treatment system into the sewer.

Results: Microbiological and chemical tests were conducted at the Afyonkarahisar Public Health Laboratory by taking water samples using the appropriate technique from various points within the hemodialysis unit's water system at Merkezefendi State Hospital. The analyses of water samples from four different points in the reverse osmosis water system, including the inlet, post-treatment, inter-tank, and rejected water sections, revealed that all these sections were microbiologically sterile (Enterocuc/Fecal streptococ, E. Coli, total coliform). Additionally, Aluminum and Iron levels were found to be zero. The Ammonium levels were 0.15, 0.13, 0.12, and 0.13 mg/L, respectively, and the conductivity was measured as 540, 546, 492, 623 mS/cm. The water was deemed suitable in terms of odor, turbidity, and color, with a pH range of 7.50-7.70, falling within the standard range established by the Turkish and USA EPA.

Conclusion: This study demonstrates that the water rejected in the reverse osmosis system can be used for all kinds of purposes. Given the decreasing availability of the world's water resources, this research represents the first national study showing that water can be conserved by preventing the disposal of water into the sewerage system, which places a burden on the economy and the natural environment.

Keywords

Rejected Water;, Hemodialysis;, Reverse Osmosis;, Green Dialysis

Hemodiyaliz Dünyanın Suyunu Tüketiyor: Ters Osmozdan Atılan Suyun Analizi ve Kullanılabilir Olması / Hemodialysis Consumes the World's Plenty of Water Water: the Analysis of Water Discharged from Reverse Osmosis and Usefulness

Abstract

Amaç: Hemodiyaliz su sisteminde ham su; şebeke veya artezyen suyunu, saf su ise; konsantre hemodiyaliz çözeltilerinin seyreltilmesinde kullanılan arıtılmış suyu tanımlamaktadır. Saf su üretilirken ters ozmoz cihazından açığa çıkan ve çoğu kez kanalizasyona atılan “reddedilen su” ile tedavi sonrası hasta kanı ile temas etmiş HD atık suyu terim olarak karıştırılmaktadır. Çalışmada amacımız reddedilen suyun kalitesini göstererek atılmasını engellemektir.

Gereç ve Yöntem: Hemodiyaliz dünyanın suyunu tüketiyor isimli çalışma için Manisa Celal Bayar Üniversitesi Etik Kurulundan onay alınmıştır. Suyun yüksek basınç altında yarı geçirgen zardan geçirilerek içindeki zararlı ve kirletici maddelerden filtrelenme işlemi ters ozmos sisteminin temel prensibidir. Çalışmamızda ters ozmos su arıtma sisteminde çıkan ve kanalizasyona giden suyun mikrobiyolojik ve kimyasal yönden analizi yapılmıştır.

Bulgular: Merkezefendi Devlet Hastanesi hemodiyaliz ünitesinde su sisteminin farklı noktalarından tekniğine uygun şekilde su örnekleri alınarak Afyonkarahisar Halk Sağlığı Laboratuvarında mikrobiyolojik ve kimyasal testler yapılmıştır. Ters ozmoz su sisteminde giriş, arıtım sonrası, tanklar arası ve reddedilen su bölümleri olmak üzere 4 farklı noktadan alınan su örneklerine yapılan analizler sonucunda bu bölümlerin tamamı mikrobiyolojik yönden (Enterocuc/Fecal streptococ, E.Coli, toplam coliform) steril, Alüminyum ve Demir düzeyleri sıfır bulunmuştur. Amonyum sırasıyla 0.15, 0.13, 0.12 ve 0.13 mg/L; kondoktivite ise 540, 546, 492, 623 mS/cm, koku bulanıklık ve renk açısından uygun, pH 7.50-7.70, aynı zamanda Türkiye ve ABD EPA standart aralığında değerlendirilmiştir.

Sonuç: Bu çalışma ile ters ozmos sisteminde reddedilen suyun her türlü amaç için kullanılabilir olduğu gösterilmiştir. Dünyada su kaynaklarının giderek azaldığı dikkate alındığında, kanalizasyona giden, ekonomiye ve doğal çevreye yük olan bu durumun önüne geçilerek bu durumda, suyun tasarruf edilebilir olmasını gösteren ulusal anlamda ilk çalışmadır.

Keywords

Atık Su;, Hemodiyaliz;, Ters Osmoz;, Yeşil Diyaliz

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