Incidence of Hypersensitivity Reactions During Hemodialysis
Background/Aims: A recent alert from Spanish health authorities warned of a higher incidence of reported hypersensitivity reactions to hemodialysis membranes with polysulfone, in the 2017 review of acute reactions to dialyzers found only published reports in the 21st century on polysulfone and its d...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2018-09-01
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| Series: | Kidney & Blood Pressure Research |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/493662 |
| _version_ | 1818775492766990336 |
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| author | Raquel Esteras Juan Martín-Navarro Gabriel Ledesma Raúl Fernández-Prado Gilda Carreño Melissa Cintra Ignacio Cidraque Ignacio Sanz Blanca Tarragón Simona Alexandru Mónica Milla Elena Astudillo Emilio Sánchez Sebastian Mas Rafael Díaz Tejeiro Alberto Ortiz Rafael Sánchez Emilio González-Parra |
| author_facet | Raquel Esteras Juan Martín-Navarro Gabriel Ledesma Raúl Fernández-Prado Gilda Carreño Melissa Cintra Ignacio Cidraque Ignacio Sanz Blanca Tarragón Simona Alexandru Mónica Milla Elena Astudillo Emilio Sánchez Sebastian Mas Rafael Díaz Tejeiro Alberto Ortiz Rafael Sánchez Emilio González-Parra |
| author_sort | Raquel Esteras |
| collection | DOAJ |
| description | Background/Aims: A recent alert from Spanish health authorities warned of a higher incidence of reported hypersensitivity reactions to hemodialysis membranes with polysulfone, in the 2017 review of acute reactions to dialyzers found only published reports in the 21st century on polysulfone and its derivatives. The aim is to assess/evaluate the current incidence and characteristics of hypersensitivity reactions in hemodialysis patients. Methods: A retrospective multicentre study in 9 Spanish hospitals evaluated patients in whom a hypersensitivity reaction required a change in dialyzer membrane. Results: A total of 37 patients out of 1561 (2.37%) had hypersensitivity reactions and clinical, epidemiological and analytical data were available for 33 patients (2.11%). The membranes involved were polysulfone (n=23), polynephron (n=8), polyethersulfone (n=1) and polyacrylonitrile (n=1). This distribution reflected the frequency of use of membranes in the participating dialysis units. The reactions were described as type A in 18 cases and type B in 15 cases. There were no significant differences between the two types in clinical symptoms, the composition of the membrane involved, the method of sterilization, the season, or the time during the session in which they occurred. The most frequent symptom was dyspnea/breathlessness (64% of reactions). Eosinophilia was common (74%). 54% of the reactions occurred within the first 30 minutes of hemodialysis, 64% occurred during the first year of dialysis, and 54% required discontinuation of dialysis session. Cellulose triacetate was used as an alternative dialyzer in 78% of the cases. Conclusion: The incidence of hypersensitivity reactions was in the range found in reports from 20 years ago and is observed associated with synthetic membranes, not just polysulfones. Cellulose triacetate appears to be a good alternative for these patients. |
| first_indexed | 2024-12-18T10:57:54Z |
| format | Article |
| id | doaj.art-4a813a40ae0e436b93f5f01d58f74772 |
| institution | Directory Open Access Journal |
| issn | 1420-4096 1423-0143 |
| language | English |
| last_indexed | 2024-12-18T10:57:54Z |
| publishDate | 2018-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Kidney & Blood Pressure Research |
| spelling | doaj.art-4a813a40ae0e436b93f5f01d58f747722022-12-21T21:10:17ZengKarger PublishersKidney & Blood Pressure Research1420-40961423-01432018-09-014351472147810.1159/000493662493662Incidence of Hypersensitivity Reactions During HemodialysisRaquel EsterasJuan Martín-NavarroGabriel LedesmaRaúl Fernández-PradoGilda CarreñoMelissa CintraIgnacio CidraqueIgnacio SanzBlanca TarragónSimona AlexandruMónica MillaElena AstudilloEmilio SánchezSebastian MasRafael Díaz TejeiroAlberto OrtizRafael SánchezEmilio González-ParraBackground/Aims: A recent alert from Spanish health authorities warned of a higher incidence of reported hypersensitivity reactions to hemodialysis membranes with polysulfone, in the 2017 review of acute reactions to dialyzers found only published reports in the 21st century on polysulfone and its derivatives. The aim is to assess/evaluate the current incidence and characteristics of hypersensitivity reactions in hemodialysis patients. Methods: A retrospective multicentre study in 9 Spanish hospitals evaluated patients in whom a hypersensitivity reaction required a change in dialyzer membrane. Results: A total of 37 patients out of 1561 (2.37%) had hypersensitivity reactions and clinical, epidemiological and analytical data were available for 33 patients (2.11%). The membranes involved were polysulfone (n=23), polynephron (n=8), polyethersulfone (n=1) and polyacrylonitrile (n=1). This distribution reflected the frequency of use of membranes in the participating dialysis units. The reactions were described as type A in 18 cases and type B in 15 cases. There were no significant differences between the two types in clinical symptoms, the composition of the membrane involved, the method of sterilization, the season, or the time during the session in which they occurred. The most frequent symptom was dyspnea/breathlessness (64% of reactions). Eosinophilia was common (74%). 54% of the reactions occurred within the first 30 minutes of hemodialysis, 64% occurred during the first year of dialysis, and 54% required discontinuation of dialysis session. Cellulose triacetate was used as an alternative dialyzer in 78% of the cases. Conclusion: The incidence of hypersensitivity reactions was in the range found in reports from 20 years ago and is observed associated with synthetic membranes, not just polysulfones. Cellulose triacetate appears to be a good alternative for these patients.https://www.karger.com/Article/FullText/493662HemodialysisDialyzerAcute reactionAllergic reactionPolysulfonePolynephronMembrane |
| spellingShingle | Raquel Esteras Juan Martín-Navarro Gabriel Ledesma Raúl Fernández-Prado Gilda Carreño Melissa Cintra Ignacio Cidraque Ignacio Sanz Blanca Tarragón Simona Alexandru Mónica Milla Elena Astudillo Emilio Sánchez Sebastian Mas Rafael Díaz Tejeiro Alberto Ortiz Rafael Sánchez Emilio González-Parra Incidence of Hypersensitivity Reactions During Hemodialysis Kidney & Blood Pressure Research Hemodialysis Dialyzer Acute reaction Allergic reaction Polysulfone Polynephron Membrane |
| title | Incidence of Hypersensitivity Reactions During Hemodialysis |
| title_full | Incidence of Hypersensitivity Reactions During Hemodialysis |
| title_fullStr | Incidence of Hypersensitivity Reactions During Hemodialysis |
| title_full_unstemmed | Incidence of Hypersensitivity Reactions During Hemodialysis |
| title_short | Incidence of Hypersensitivity Reactions During Hemodialysis |
| title_sort | incidence of hypersensitivity reactions during hemodialysis |
| topic | Hemodialysis Dialyzer Acute reaction Allergic reaction Polysulfone Polynephron Membrane |
| url | https://www.karger.com/Article/FullText/493662 |
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