Evaluation of Synthetic PES Membranes for Relative Endotoxin Reduction in Dialysis Water Yasamen R. Humudat, Mohammed A. Abdul‐Majeed, Lubna A. Najim Water Environment Research, 2026 Ensuring the microbiological safety of dialysis water is a critical requirement in hemodialysis practice. Contamination with bacterial endotoxins poses a serious risk to patient health, particularly in regions with limited access to advanced purification systems. Developing affordable and effective local alternatives can significantly improve dialysis water quality and patient safety. This study aimed to develop and evaluate a locally fabricated synthetic membrane for the removal of bacterial endotoxins from dialysis water, providing a safe and cost‐effective purification solution suitable for resource‐limited healthcare environments. The fabricated membrane was tested in vitro using Limulus amebocyte lysate (LAL) assay for quantitative endotoxin detection, contact angle measurement to assess surface wettability, and scanning electron microscopy (SEM) for morphological characterization. The performance of the membrane alone and in combination with ultrasound treatment, ultraviolet treatment, magnetic treatment, and ozone was compared to determine the most efficient treatment configuration. The results showed that combining membrane filtration with ozonation achieved the highest relative endotoxin reduction (~87%) , outperforming the membrane‐only system. The membrane exhibited a contact angle of 67°, indicating moderate hydrophilicity favorable for stable filtration performance. SEM analysis revealed a uniform, defect‐free porous surface with pore sizes ranging from 0.5 to 2 μm, confirming effective endotoxin retention and structural integrity. This study demonstrates the feasibility and effectiveness of integrating locally produced synthetic membranes with ozonation as a practical, efficient, and sustainable approach to improving dialysis water quality. The proposed system offers a promising low‐cost alternative for enhancing patient safety and can be adapted in healthcare centers with limited technical resources.
Seasonal dynamics of endotoxin in dialysis water: one-year surveillance in Iraq Yasamen R. Humudat Journal of Water and Health, 2026 Dialysis water quality is critical to patient safety, particularly in relation to bacterial endotoxins, which can pose major health hazards. Environmental variables, such as seasonal flocculation, may influence endotoxin levels in treated water. The purpose of this study was to evaluate the seasonal fluctuation in endotoxin concentrations in dialysis water across a number of hospital-based dialysis centers. Over 12 months, water samples were collected monthly from various places and tested for endotoxin levels using the Limulus Amebocyte Lysate (LAL) assay. The findings demonstrated considerable seasonal changes, with almost 55.5% of the samples surpassing the international threshold of 0.03 EU/mL. Peaks were seen during the warmer months (July–August 2025 and February–March 2025), whereas lower levels were more typical in the winter (November–December 2024). These findings highlight the requirement for seasonally adjusted monitoring and control strategies to maintain water quality and ensure patient safety in dialysis settings.
Membrane filtration enhanced by magnetic field for reducing endotoxin from dialysis water Yasamen R. Humudat, Mohammed A. Abdul-Majeed, Ali Ch. Khraibet Desalination and Water Treatment, 2024 This study investigates the impact of magnetic field-assisted filtration on endotoxin reduction in dialysis water, focusing on the efficacy of ultrafiltration and nanofiltration membranes. The starting material was synthetic water with a known amount of endotoxin (0.48 EU/ml). The experiment was conducted in a small-lab-scale unit, likely to test and optimize the purification method before large-scale application. Limulus amebocyte lysate (LAL) assay is a standard test used to detect and quantify endotoxin levels in liquids. The study found that all treatment strategies effectively reduced endotoxin levels, with the best treatment being a third hybrid treatment involving magnetic field, UF, and NF exposure. This kind of treatment reduced the endotoxin from 0.169 ± 0.09 EU/ml to 0.06 ± 0.06 EU/ml at an exposure time of 20 min for a magnetic field. The integration of magnetically treated water in dialysis treatment plants holds promise for enhancing the quality of dialysis fluid and aligning with international standards. By employing physical methods like magnetic treatment, facilities can address concerns surrounding water purity in dialysis, which is crucial for patient safety and treatment effectiveness.
Assessment of the impact of anemia on hematological parameters among hemodialysis patients with chronic kidney disease Yasamen Raad Humudat Bionatura, 2023 Anemia is a common consequence of chronic kidney disease (CKD) that is linked to a decrease in patients' quality of life, a rise in morbidity and mortality, and an acceleration in CKD progression. This study aimed to investigate the hematological profile of chronic renal patients undergoing hemodialysis and to correlate the same with anemia. Fifty (54% males and 46% females) with ages ranging from 18-76 years of patients with CKD and on regular maintenance hemodialysis not less than three months at the Iraqi center for dialysis in Baghdad teaching hospital, and 30 healthy adults were recruited into the study. Hemoglobin concentration, red cell count, white blood cell count, platelet count, ESR, CRP and HCV were assessed for the subjects and controls. Results were analyzed using a t-test independent, and the data were retrieved from the laboratory information system in the hospital. Red blood cell count was reduced in nearly all (96%) of the study patients, while ESR was elevated in (98%) and CRP was elevated in (95%). All patients suffered anemia in HD patients. Most of the patients' WBCs and platelet counts were normal. Anti-HCV antibodies were positive in 15 (30%) of these patients, with non-significant differences in both genders. The study concludes that anemia is a significant comorbidity in hemodialysis patients, with several factors contributing to it, and thorough workup and successful treatment of anemia are essential in this group of patients. Keywords: Anemia; Hematological profile; Hemodialysis; Hepatitis; chronic kidney disease
Endotoxin quality of ultrapure dialysis fluid for online hemodiafiltration in several hemodialysis centers Yasamen Raad Humudat Bionatura, 2023 Globally, the nephrology community is seeing a rise in the use of high-flux membranes and ultrapure water in hemodialysis (HD) machines. However, data on HD water quality could be more extensive in low- and middle-income countries. The Ministry of Health in Iraq issued a rule requiring a gradual modification in the HD water treatment system to adopt ultrapure water in all dialysis centers. The current study aimed to monitor the endotoxin of ultrapure dialysis fluid at several centers in Iraq and the clinical benefits of its use. This work evaluated the quality of ultrapure water used for dialysis in twenty-one dialysis centers within various Iraqi province hospitals. The samples were collected for 4 months from January to April 2022. Endotoxin tests in ultrapure dialysis fluid were measured by Gel Clot assay. Results showed an unacceptable difference in the ultrapure dialysis fluid's quality compared to the international standard (ANSI/AAMI/ISO-23500). Endotoxin levels in 33% of ultrapure dialysis fluid above 0.03 EU/ml, exceeding recommended international standards. The findings highlight the importance of assessing water quality in medical facilities to ensure patient safety and encourage sanitary monitoring of this procedure as a healthcare promoter. Keywords: Ultrapure water; Hemodiafiltration; Dialysis fluid; Endotoxin; Public Health Reform.
Assessment of endotoxin levels of water in hemodialysis centers in Iraq Yasamen Raad Humudat, Saadi Kadhim Al-Naseri Bionatura, 2023 The significance of endotoxin-free, sterile dialysis fluid for long-term, high-quality hemodialysis treatment is obvious and highly desired[MF1] . The current study aimed to determine endotoxin for the water quality used in twenty hemodialysis treatment centers. Eighty samples (40 x dialysates and 40 x dialysis water) were tested for endotoxin using the LAL gel clot method. The results revealed a variation in the quality of the produced water that makes it unaccepted compared to the international standard (ANSI/AAMI/ISO-23500). Endotoxin levels were higher than (0.25 EU/ml) in 40% of dialysis water and 30% of dialysate water, higher than the recommended international standards. The results conclude that systematic water quality monitoring in hemodialysis services is essential for patient safety and health problems. Keywords: Endotoxin; Water quality; Dialysis fluid; LAL test; Hemodialysis patient
Water treatment for hemodialysis in Baghdad medical city, Iraq Yasamen Raad Humudat, Saadi Kadhim Al‐Naseri, Natheer Jamal Imran Environmental Quality Management, 2022 Abstract Water quality for dialysis fluid is an important consideration for dialysis patients. As a result, strict monitoring of water quality is required to avoid complications and ensure the safety and health of patients. The current study aimed to determine the water quality used in hemodialysis treatment centers. Twenty water samples were collected and analyzed from three hospitals in Baghdad's medical city over four seasons. Counts of bacteria and chemical contaminants were determined in raw and dialysis water from each of four dialysis centers. After collecting samples, bacteriological and chemical analyses were performed in the laboratory. Results show that the quality of dialysis water fluctuates, making it unacceptable when compared to international standards. Bacterial counts were above the maximum value of 100 CFU/ml in 50% of the samples tested. Chemical analysis showed that the dialysis water quality suffers from elevated free chlorine concentrations in some dialysis centers. Also, there were no significant differences between the measured parameters in the dialysis water at four treatment centers during the study period at p < 0.05. Hemodialysis centers require constant monitoring, maintenance, and the development of water treatment systems to ensure optimum water quality. Additional disinfection is essential in order to prevent bacterial growth and biofilm formation.
Inactivation of Escherichia coli in water by using ultrasonic disinfection processes Yasamen Raad Humudat, Saadi Kadhim Al-Naseri, Mahdi Shanshal Jaafar's Desalination and Water Treatment, 2021 The current conventional disinfection for municipal water relies primarily on chlorine disinfection alone, in spite of its high running cost and its production of disinfection by-products. Ultrasonic disinfection is a physical technology widely accepted and continuously appraised as an alternative to conventional techniques for water disinfection. The efficiency of using the ultrasonic disinfection technique was evaluated and compared to the conventional chlorination technique using HOCl. Hybrid treatment was also investigated via the combination of both types of treatment. A laboratory-scale unit was constructed to carry out disinfection experiments using synthetic water (feed solution) prepared with a known concentration of Escherichia coli. The results showed that all the tested treatment methods are capable, to some degree, of inactivating E. coli in water. However, the best treatment option was achieved when coupling ultrasonic and HOCl for disinfection. This kind of treatment significantly reduces the concentration of bacteria higher than using each treatment alone. Thus, the ultrasonic technique is a better option for disinfection enhancement when combined with HOCl, in terms of inactivation of E. coli bacteria in municipal water.
Evaluation Of Microbiological Contamination From Dialysis Water And Fluids At Several Hospitals In Baghdad Indian Journal of Environmental Protection, 2021
