**2. Sampling of activated charcoals**

148 Technical Problems in Patients on Hemodialysis

renal insufficiency, as well as the mechanisms of their monitoring , moreover the need of risk reduction to which the dialysis patients are submitted , the ANVISA (The National Agency of Sanitary Surveillance) has established as resolution (RESOLUÇÃO-RDC nº 154, of June 15th, 2004, republished in May 31, 2006) which foresees the technical regulation for

It was established from that resolution's publication, that the water used in the preparation of dialysate, must have its quality guaranteed in all phases of the treatment, storage and distribution through the monitoring of the microbiological and physic-chemical parameters, as well as the procedures for the treatment themselves. Therefore, the water provision of the dialysis services from the public supply, from wells and any other sources must have its drinking standard as provisioned in the Act MS Nr. 518 of March 25th, 2004, (Brazilian Health Ministry) or of any legal instrument which may replace that one. Regarding the cyanotoxins, according to the art. 14 of this regulation, it was established that the upper limit allowed of microcystins in water for public supply be of 1 g/L, it was also recommended that the analysis for the cyanotoxins included the determination of cylindrospermopsin and saxitoxins (STX), taking into consideration, respectively, the value

A good example of cyanotoxins monitoring is being made in the systems of water collection which supply the city of São Paulo, Brazil (systems Rio Grande, Alto Tiête and Guarapiranga) by the Basic Sanitation Company and water treatment of São Paulo,- SABESP. It has been noticed that despite the mycrocystin levels are below the standard established by the MS 518/2004, many Hemodialysis clinics, in where this water is used, are at alert, as the water used by them for the Hemodialysis treatment needs to be with

In Brazil, according to the Brazilian Society of Nephrology, in order to guarantee the water quality used for renal patients, more than 80% of the Hemodialysis centers have water treatment systems which use reverse osmoses, deionization, integrated system of reverse

The granulated activated charcoal (GAC) is an adsorbent used in processes of water treatment (activated charcoal filters) to remove micropollutants present in water, as pesticides, industrial chemical agents, cyanobacterial secondary metabolites such as geosmim and 2-methyl isoborneol (MIB) which give taste and odor to water, and toxins like

The adsorption capacity of activated charcoals (AC) by compounds in the water is mainly influenced by the physical structure and chemical characteristics of the surface of these adsorbents, their previous material, and their preparation condition (Newcombe, 1999; Karanfil et al., 1999). Different research groups have shown that the ACs with pore volume developed in the regions of mesopores and secondary micropores can be very effective in the removal of microcystins (Falconer et al., 1989; Donati et al., 1994; Pendleton et al. 2001; Campinas & Rosas, 2010a, 2010b). Therefore, it is indispensable to estimate the distribution of pores in these regions, whether by means of adsorbing in liquid phase by using the

The Hemodialysis Centers are concerned with the correct quality parameters which would indicate from those parameters which is the best charcoal to be used in their water treatment, as the activated charcoal, associated with other technologies, is commonly used by water treatment stations in Hemodialysis Centers. Thus, in this Chapter, are discussed the adsorption techniques in liquid and gaseous phase which were used aiming to assess the

the functioning of these services in Brazil.

limits of 15.0 µg/L e 3.0 µg/L of STX/L equivalents.

osmoses + deionization, besides activated charcoal.

methylene blue solution or in gaseous phase using N2.

hepatotoxins (microcystins) and neurotoxins (Newcombe, 1999).

microcystins concentration equal to zero.

Activated charcoals used in two Brazilian Hemodialysis Centers, located in the city of Recife/Pernambuco, Brazil - Hemodialysis Center of the Clinical Hospital of the Federal University of Pernambuco, coordinates 08º03'15.40''S 34º52'52.52''W (termed A) - and in the city of Campinas/São Paulo, Brazil - Hemodialysis Center of the Clinical Hospital of the State University of Campinas, coordinates 22º54'25.58''S 47º03'47.66''W (termed B) - were used in this study. Besides that, sugarcane bagasse (CA-R-H) and dry coconut shell (CA-R-G) based-activated charcoal were specially produced for this work and used as reference charcoals (termed R) (Table 1). These charcoals were activated with water steam at temperature close to 900 ºC. The raw material preparation conditions, the carbonization and activation, besides those charcoals full characteristics, in liquid and gaseous phase, are thoroughly described by Albuquerque Junior et al. (2005)\*.


Table 1. Assessed Activated Charcoals
