Vial spiking assemblies and related methods

A dialysis system comprising:

• a dialysis machine comprising:
• a blood pump;
• and
• a drug pump;
• a blood line set comprising a blood line that can be operably connected to the blood pump and a drip chamber in fluid communication with the blood line;
• and
• a fluid line set comprising a fluid line that can be connected to the drip chamber of the blood line set and to a vial adapter, the vial adapter comprising:
• a base;
• a spike extending from a central region of the base;
• and
• a sidewall extending from the base and substantially surrounding the spike, the base and the side wall at least partially defining a cavity configured to receive a portion of a vial;
• and
• a spike cover removably attachable to the spike, wherein the spike cover comprises a microporous material configured to indicate when the material has been contacted with liquid, wherein the microporous material has an average pore size capable of permitting air to flow through and preventing liquid from flowing through.