2008-12-05 / Columnists

SJEH Wellness Corner

Eco-Dialysis at St. John's Episcopal Hospital
Commentary By A. Rashad, Technical Manager, Marjorie Basser Hemodialysis Center St. John's Episcopal Hospital

The Marjorie Basser Hemodialysis Center of St. John's Episcopal Hospital is working hard to provide quality care to patients. Reducing our Center's ecological footprint - the measure of how our lifestyles affect the earth and its ability to regenerate resources - is something we consider a vital part of raising the standards of quality care. In order to do this, the Center has made several progressive changes in its operational use of energy, light, water consumption rate, chemical disinfectants, recyclables and inventory.

Water is a key ecological resource. Though 70 percent of the planet is covered by water, less than one percent is available for human use. The U.S. government predicts there will be water shortages in 36 states between now and 2013.

Hemodialysis is a very water-intensive process. According to recent literature, people with working kidneys may drink 10 to 14 liters of water a week. In comparison, most dialysis patients are exposed to 270 to 576 liters of water per week (via dialysate, a mixture of treated water and carefully measured chemicals used to clean the patient's blood during hemodialysis.)

The first thing the Center did to calculate its ecological footprint was to conduct a water audit. To help decrease water loss we focused on seal- ing leaks in the hemodialysis water distribution loop.

Next we turned our attention to our water purification system. A dialysis patient is exposed to very large amounts of dialysate that come into close contact with his or her blood. Tap water contains a large number of substances that have had proven fatal effects on dialysis patients. Water used for dialysis must therefore be purified through a process called reverse osmosis. In reverse osmosis, pressurized water is forced through a semipermeable membrane that allows the passage of purified water (product) but retains most of the dissolved salts, particles, bacteria and endotoxins that are not appropriate for dialysis.

The Hospital's dialysis water purification system, the Gambro Central Water Plant©, not only performs this monumental task daily with the most technological efficiency but is ecologically advanced as well. The Gambro water plant has a water-saving control feature that salvages the excess portion of product water and part of the rejected water. In addition, any remaining reject water is used to carry away heat generated by the water pump. The Gambro's reverse osmosis system is the only one in the world equipped with this water-saving technology. This same product water is heated nightly to 194 degrees and recirculated through the product water distribution loop for disinfection purposes; no harsh chemical disinfectants are needed.

At the Marjorie Basser Hemodialysis Center, we continue to plan to improve our operational efficiency and reduce our carbon footprint. Besides the positive impact St. John's hemodialysis team has on our patients, we also feel enthusiastic about how much greener we are keeping our environment. We believe that being green is an essential part of our core values for providing high standards of care to our patients.

For more information about the greening of hemodialysis or the Marjorie Basser Hemodialysis Center at St. John's Episcopal Hospital please call 718-869-5139.

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