They remove almost all of the disolved solids from tap water, they produce, depending on the quality of the unit, (which is reflected in the price), and the quality of the tap water, very pure water.
I have used RO units for more then 15 years now because I need soft water for breeding.
Something to be aware of is the water they produce is too pure to be used straight from the unit. It has no buffering capability and can swing wildly in pH. It is necessary to stabilise the RO water by using certain salts. Kent RO right is what I use.
Unless you are breeding difficult fish or want to top up marine tanks without adding additional salts, they are not necessary.