This is the second edition of CAN/CSA-Z23500, Guidance for the preparation and quality management of fluids for haemodialysis and related therapies, which is an adoption, with Canadian deviations of the identically titled ISO (International Organization for Standardization) Standard 23500 (second edition, 2014-04-01). It supersedes the previous edition published in 2012 as CAN/CSA-Z23500 (adopted ISO 23500:2011).
This International Standard provides dialysis practitioners with guidance on the preparation of dialysis fluid for haemodialysis and related therapies and substitution fluid for use in online therapies, such as haemodiafiltration and haemofiltration. As such, this International Standard functions as a recommended practice.
This International Standard addresses the user’s responsibility for the dialysis fluid once the equipment used in its preparation has been delivered and installed. For the purposes of this International Standard, the dialysis fluid includes dialysis water (see 3.18 for definition) used for the preparation of dialysis fluid and substitution fluid, dialysis water used for the preparation of concentrates at the user’s facility, as well as concentrates and the final dialysis fluid and substitution fluid.
The scope of this International Standard includes
a) the quality management of equipment used to treat and distribute water used for the preparation of dialysis fluid and substitution fluid, from the point at which municipal water enters the dialysis facility to the point at which the final dialysis fluid enters the dialyser or the point at which substitution fluid is infused
b) equipment used to prepare concentrate from powder or other highly concentrated media at a dialysis facility, and
c) preparation of the final dialysis fluid or substitution fluid from dialysis water and concentrates.
NOTE Because water used to prepare dialysis fluid is commonly prepared and distributed using the same equipment as the water used to reprocess dialysers, water used to reprocess dialysers is also covered by this International Standard.
This International Standard does not apply to sorbent-based dialysis fluid regeneration systems that regenerate and recirculate small volumes of dialysis fluid, systems for continuous renal replacement therapy that use prepackaged solutions, and systems and solutions for peritoneal dialysis.