A modern system is a multi-barrier defense, with each component designed to remove specific contaminants. The typical sequence includes:

• Pre-treatment: This includes sediment filters (remove dirt and rust), carbon tanks (adsorb chlorine and chloramines, which are highly toxic to dialysis patients), and water softeners (remove calcium and magnesium to prevent "hard water" from damaging the equipment).

• Primary Treatment: The heart of the system is Reverse Osmosis (RO). The RO pump forces water through a semi-permeable membrane that removes over 90-99% of all remaining contaminants, including ions, viruses, and bacteria. It is the single most important purification step.

• Final Treatment: After the RO, the purified water may pass through an ultraviolet (UV) light sterilizer to kill any remaining bacteria. Finally, a sub-micron filter (often called an "endotoxin filter") is used to capture any bacterial fragments (endotoxins) before the water is delivered to the dialysis machines.

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