Hemolysis During Hemodialysis

Sam, Ramin; Haghighat, Leila; Kjellstrand, Carl M.; Ing, Todd S.

doi:10.1016/b978-1-4160-4197-9.50035-1

Cited by 8 publications

(35 citation statements)

References 11 publications

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“…Acute haemolysis from shear stress is the result of resistance or obstruction to blood flow though the extracorporeal circuit caused by manufacturing errors, kinked blood tubing, excessive dialysate flow through small gauge cannula, and needling factors including malposition and single needle technique …”

Section: Causesmentioning

confidence: 99%

“…Red blood cells (RBC) forced through a narrow orifice or channels are subject to significant turbulence and shear strain. Red cell fragmentation syndrome describes the phenomenon whereby intravascular mechanical trauma results in damaged and misshapen RBC that are very susceptible to haemolysis …”

Section: Causesmentioning

confidence: 99%

“…Mechanical obstruction can occur at various points along the extracorporeal circuit including the needle, catheter, tubing and blood pumps. Many studies describe outbreaks of haemolysis secondary to kinked tubing, and some report on malocclusion at the level of the blood pump …”

Section: Causesmentioning

confidence: 99%

“…A malpositioned arterial needle that directly abuts the vascular access wall can obstruct blood flow. The resultant vacuum can result in flow turbulence and collapse of the vascular access tubing resulting in haemolysis . The effects are exaggerated with vascular access stenosis and thrombosis that further restrict blood flow.…”

Section: Causesmentioning

confidence: 99%

“…Chloramine is one of the most common disinfectants used in the treatment of water used for haemodialysis. Many worldwide outbreaks of haemolysis in dialysis centers have been linked to chemical contamination, particularly chloramine . Other compounds such as formaldehyde and metals including copper and zinc have also been attributed to causing haemolysis however outbreaks have not been reported in recent times .…”

Section: Causesmentioning

confidence: 99%

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Haemolysis in haemodialysis

Tharmaraj

Kerr

2017

Nephrology

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ABSTRACT:Haemolysis in haemodialysis, although rare in current times, is associated with significant mortality and morbidity. As such prompt recognition, treatment, analysis of root cause and correction of underlying causative factors is crucial. Dialysate, extracorporeal circuit and patient related factors all contribute to haemolysis risk. Haemolysis can manifest with non-specific signs and symptoms including but not restricted to hypertension, nausea, pain (abdominal, chest, back) and dyspnoea. It may present acutely during the dialysis session or may take a protracted course. Potential life threating consequences include; hyperkalaemia induced cardiac arrhythmias, profound anaemia and associated acute coronary events and respiratory distress, and severe necrotizing pancreatitis. Chronic haemolysis results in impaired endothelial function thus contributing to the long-term cardiovascular risk profile in haemodialysis patients. Stringent national and international standards, technological advancements in membrane and dialysis equipment design, dialyser purification methods and water treatment systems have greatly reduced the incidence of haemolysis. Despite these improvements recognition of haemolysis risk and ongoing clinical vigilance is important.

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Section: Causesmentioning

confidence: 99%

Section: Causesmentioning

confidence: 99%

Section: Causesmentioning

confidence: 99%

Section: Causesmentioning

confidence: 99%

Section: Causesmentioning

confidence: 99%

See 3 more Smart Citations

Haemolysis in haemodialysis

Tharmaraj

Kerr

2017

Nephrology

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Does the use of infusion pumps increase hemolysis during blood transfusion in patients with thalassemia?

Yılmaz¹,

Gökçebay²,

Yilmaz³

et al. 2022

Transfusion and Apheresis Science

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A rare case of dialysis associated reaction presenting with urticarial vasculitis and haemoglobinuria

Jayaprakash,

Mathew,

Muthukarupiah

et al. 2024

Nephrology

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Dialysis associated reactions presenting with urticarial vasculitis is rarely reported in medical literature. We report a 61‐year‐old gentleman who developed sudden onset dyspnea with diffuse erythema within 20 min of haemodialysis. Patient was started on Azilsartan 3 days prior to this clinical event. Labs revealed features of hemolysis and urine was positive for hemoglobinuria. All dialysis related factors responsible for this reaction were ruled out. Due to non‐resolution of skin rash, skin biopsy was attempted which revealed fibrinoid necrosis of occasional vessels with predominant lymphocytic infiltration suggestive of drug induced urticarial vasculitis. Complement levels were normal. He was managed with steroids, anti‐histaminic, discontinuation of azilsartan and change of dialyzer membrane. This case highlights a rare dermatological presentation of Type A dialysis associated reaction involving azilsartan with differential diagnosis and treatment strategies.

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Hemolysis During Hemodialysis

Cited by 8 publications

References 11 publications

Haemolysis in haemodialysis

Haemolysis in haemodialysis

Does the use of infusion pumps increase hemolysis during blood transfusion in patients with thalassemia?

A rare case of dialysis associated reaction presenting with urticarial vasculitis and haemoglobinuria

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