is checking the conductivity and ph with an external meter before tx is a regulation or a recomendation?????.

thanks.

Hi Alex2,
Checking the conductivity and pH of the dialysate solution is a manufacturers recommendation (dialysis equipment and concentrate manufacturers). Now, to follow manufacturer recommendations, "Is an AAMI Standard".
Good luck.

Conductivity, ph and temperature should be checked with an external meter the entire tx for maximum stability!

My opinion on this is that the redundent monitors and alarms in a well calibrated machine make it unimportant to check conductivity and temperature externally.
This would apply to most machines made today. The requirement to do an external check is I believe a throwback to the older equipment. The new equipment monitors at all times.

Regular maintenance according to manufacturers specifications with (gold standard) calibrated external meters for conductivity and temperature is what is important.

ANSI/AAMI RD5-1992 ( 2001 Edition of AAMI Standards and Recommended Practices -Dialysis, p23 Appendix A Section A3.1.1) states:
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" Adequate monitoring does not currently exist to assure that mismatched concentrates will not produce a final dialysate of proper total conductivity but improper composition. The user is cautioned not to rely solely on conductivity measurements to ensure safety, but to consider all relevant factors, including pH. Recognition and application of appropriate concentrates to produce the desired result is the responsibility of the operator." (end quote)
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Conductivity alone will not detect some types of dialysate proportioning errors caused by bicarb mixing errors, mismatch of cartridge to machine, or machine software or mechanical malfunction.

Adding a second instrument or test strip pH reading will catch some additional errors; but is not fool proof. However, some dialysis providers feel the extra pH reading adds some extra protection.
Ken Price , Serim

Allow me to qualify my previous statement. The type of machine is a huge consideration. Almost all have pH probes these days and they were added primarily to detect concentrate errors. Machines that do not have both monitor and control conductivity cells for bicarb, acid and or final conductivity may be prone to not alerting the operator to errors. Consider one machine on the market that when the concentrates were hooked up in the wrong order the machine assumed it was in acetate mode.