Hypersensitivity reactions to acetate in the bicarbonate dialysate in a patient undergoing pre-dilution online hemodiafiltration

CEN Case Reports
Akihiko KatoMitsuyoshi Furuhashi

Abstract

A 63-year-old male patient first experienced recurrent hypotensive episode during the dialysis session just after switching the mode from hemodialysis to online hemodiafiltration (OL-HDF) with infusion in pre-dilution of the bicarbonate dialysate containing 9.2 mEq/L of acetate. Peripheral eosinophil count and serum IgE were both elevated to 16,440/μL and 2000 IU/L. The reactions promptly dissolved with substitution of acetate-free solution. This case illustrated that pre-dilution OL-HDF can induce an occult hypersensitivity to acetate in the standard bicarbonate dialysate.

References

Feb 9, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Francesco PizzarelliGiuseppe Ferro

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