<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0211-6995</journal-id>
<journal-title><![CDATA[Nefrología (Madrid)]]></journal-title>
<abbrev-journal-title><![CDATA[Nefrología (Madr.)]]></abbrev-journal-title>
<issn>0211-6995</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Nefrología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0211-69952016000300013</article-id>
<article-id pub-id-type="doi">10.1016/j.nefro.2016.01.003</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Guía de gestión de calidad del líquido de diálisis (LD) (segunda edición, 2015)]]></article-title>
<article-title xml:lang="en"><![CDATA[Guideline for dialysate quality of Spanish Society of Nephrology (second edition, 2015)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-García]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Maset]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A2"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonzalez Parra]]></surname>
<given-names><![CDATA[Emilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solozábal Campos]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez Chamond]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martín-Rabadán]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sobrino Pérez]]></surname>
<given-names><![CDATA[Pedro Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallego Pereira]]></surname>
<given-names><![CDATA[Ovidio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dominguez]]></surname>
<given-names><![CDATA[Jon]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cueva Matute]]></surname>
<given-names><![CDATA[Enrique de la]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferllen]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Infanta Leonor  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital de Manises  ]]></institution>
<addr-line><![CDATA[Manises Valencia]]></addr-line>
<country>España</country>
</aff>
<aff id="A12">
<institution><![CDATA[,SEN Junta Directiva ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Fundación Jimemez Díaz  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario de Navarra  ]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad de Alcalá Facultad de Medicina y Ciencias de la Salud Departmento de Biología de Sistemas]]></institution>
<addr-line><![CDATA[Alcalá de Henares Madrid]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Universitario General Gregorio Marañón  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Hospital Universitario de la Princesa  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Tekogal Electromedicina S.L. FSE Medical Devices ]]></institution>
<addr-line><![CDATA[Vigo Pontevedra]]></addr-line>
<country>España</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Fresenius Medical Care España  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="A10">
<institution><![CDATA[,Tratamientos de Agua, Baxter Gambro Iberia  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Diaverum España  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>36</volume>
<numero>3</numero>
<fpage>e1</fpage>
<lpage>e52</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0211-69952016000300013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0211-69952016000300013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0211-69952016000300013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La Sociedad Española de Nefrología elaboró en 2004 una Guía de Gestión de Calidad del Líquido de Diálisis. La segunda edición revisada de la guía ha tenido en cuenta nuevas evidencias y la normativa internacional. En la guía se hacen algunas recomendaciones sobre normas para preparar el líquido de diálisis: agua, concentrados y sistemas de dosificación de la hemodiálisis. Esta guía se basa en la norma ISO13959, la Farmacopea Europea, la Real Farmacopea Española, las normas y prácticas recomendadas de la AAMI, la Guía Europea de Buena Práctica en Hemodiálisis, revisiones de la bibliografía, según su nivel de evidencia, y la opinión del grupo español de expertos. Se definieron 2 niveles de calidad del agua: agua purificada y agua purificada de alta calidad (ultra pura), y para el líquido de diálisis: líquido de diálisis ultra puro. El uso habitual de líquido de diálisis ultra puro se recomienda en todo tipo de hemodiálisis para prevenir y retrasar la aparición de complicaciones: inflamación, desnutrición, anemia y amiloidosis. Los requisitos de la calidad del agua, de los concentrados y del líquido de diálisis se definen como los niveles máximos admisibles de contaminantes: sustancias químicas (4.1.2), conductividad, microbiana y endotoxinas (4.1.1):           Microbiana (UFC/ml) Endotoxinas prueba LAL (UE/ml)   Agua purificada &#8804; 100 UFC/ml &#8804; 0,25  Agua ultra pura &#8804; 10 UFC/100 ml &#8804; 0,03  Líquido de diálisis ultra puro &#8804; 10 UFC/100 ml &#8804; 0,03 Se especificaron la frecuencia de control, el mantenimiento y las medidas correctivas. Los métodos de muestreo y análisis se describieron en los anexos. Para el control microbiológico es recomendable el medio de cultivo R2A, incubado durante 7-14 días a una temperatura de 17-23 °C. El proceso de garantía de la calidad del líquido de diálisis implica a todos los miembros del personal de diálisis y exige protocolos estrictos. El médico a cargo de la hemodiálisis tiene la responsabilidad final de la calidad del líquido de diálisis. Pueden dirigir sus sugerencias y preguntas acerca de esta guía a www.senefro.org.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract A Best Practice Guideline about Dialysis fluid purity was developed under the leadership of the Spanish Society of Nephrology in 2004. The second edition revised Guideline considered new evidences and International Standard. The Guideline has established recommendations for standards for preparing dialysate: water, concentrates and hemodialysis proportioning systems. This Guideline is based on the ISO13959, European Pharmacopoeia, the Real Farmacopea Española, the AAMI Standards and Recommended Practices, European Best Practice Guidelines for Haemodialysis, literature reviews, according to their level of evidence, and the opinion of the expert Spanish group. Two levels of quality of water were defined: purified water and high purified water (ultra pure) and for dialysate: ultra pure dialysate. Regular use of ultra pure dialysate is recommended for all type of hemodialysis to prevent and delay the occurrence of complications: inflammation, malnutrition, anaemia and amiloidosis. Water, concentrates and dialysate quality requirements are defined as maximum allowable contaminant levels: chemicals (4.1.2), conductivity, microbial and endotoxins (4.1.1):           Microbial (CFU/ml) Endotoxins LAL test (EU/ml)   Purified water &#8804; 100 CFU/ml &#8804; 0,25  High purified water &#8804; 10 CFU/100 ml &#8804; 0,03  Ultra pure dialysate &#8804; 10 CFU/100 ml &#8804; 0,03 Monitoring frequency, maintenance and corrective actions were specified. Methods of sampling and analysis were described in appendix (anexos). For microbiological monitoring, R2A medium is recommended, incubated during 7-14 days at a temperature of 17-23 °C. The dialysate quality assurance process involves all dialysis staff members and requires strict protocols. The physician in charge of hemodialysis has the ultimate responsibility for dialysate quality. All suggestions and questions about this Guideline are wellcome to www.senefro.org.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Líquido de diálisis]]></kwd>
<kwd lng="es"><![CDATA[Tratamiento de agua para hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[Hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[Concentrado]]></kwd>
<kwd lng="es"><![CDATA[Endotoxinas]]></kwd>
<kwd lng="en"><![CDATA[Dialysate]]></kwd>
<kwd lng="en"><![CDATA[Water treatment for dialysis fluid]]></kwd>
<kwd lng="en"><![CDATA[Hemodialysis]]></kwd>
<kwd lng="en"><![CDATA[Concentrate]]></kwd>
<kwd lng="en"><![CDATA[Endotoxins]]></kwd>
</kwd-group>
</article-meta>
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