Professor Radia Ben Semman, a lecturer at the Faculty of Pharmacy and an official at the Ministry of Health, has called for a review of the rules governing water quality in hemodialysis. She said the framework should reflect scientific and technical developments as well as current international standards. Water used to prepare dialysis fluid is vital to patient safety, with a single session potentially requiring around 150 litres.
Proposals include revising the regulatory decision issued in 2002 and extending oversight across the entire system, from treatment plants to distribution networks. Sampling and physical, chemical and microbiological testing procedures would also be standardized. Ben Semman further called for mandatory testing for endotoxins, which she described as an important indicator of water safety.
Nabil Blek, president of the Algerian Association of Nephrology, stressed the need to distinguish endotoxin measurements from tests for viable microorganisms, since the two indicators assess different aspects of water quality. He also recommended daily measurement of total chlorine at treatment plants to monitor its level and limit potential effects on water treatment and distribution.
For microbiological testing, the recommendations call for consistent detection methods and incubation conditions. The proposed approach involves incubation at 22°C for seven days using low-nutrient culture media, including R2A and TGEA. The association also recommends aligning national requirements with the international standard ISO 23500 and updating reference limits for several chemical elements.
The association warned that failures in water treatment, storage or distribution could create chemical or microbiological risks. Continuous monitoring at every stage is therefore needed to protect patients and help ensure the safety and quality of dialysis treatment.