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Introduction/ Background Hemodialysis can sustain the life of a patient; however, it can cause life-threatening issues if the treatment water is contaminated. Dialysis water testing for endotoxins is ... Introduction/ Background Hemodialysis can sustain the life of a patient; however, it can cause life-threatening issues if the treatment water is contaminated. Dialysis water testing for endotoxins is essential to patient safety. If certain amounts of endotoxin are introduced into the bloodstream or spinal fluid via a parenteral drug or medical device, fever, septic shock, organ failure, or even death can occur. The Association for the Advancement of Medical Instrumentation has published both standards and recommended practices that address both water and the dialyzing solutions. Some of these recommendations have been adopted into Federal Regulations by the Centers for Medicare and Medicaid Services as part of the Conditions for Coverage, which includes limits on specific contaminants within water used for dialysis, dialysate, and substitution fluids. Chemical, bacterial, and endotoxin contaminants are health threats to dialysis patients.