Hemolysis in a Patient during Hemodialysis

We report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritone...

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Autores principales:	Maxime Taghavi, Lucas Jacobs, Saleh Kaysi, Maria do Carmo Filomena Mesquita
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	hemolysis hemodialysis faulty blood tubing sets kinking of bloodlines Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/a3cbbb31ba7e46b8912344dd75c29fbb
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spelling	oai:doaj.org-article:a3cbbb31ba7e46b8912344dd75c29fbb2021-12-02T12:40:23ZHemolysis in a Patient during Hemodialysis2296-970510.1159/000520559https://doaj.org/article/a3cbbb31ba7e46b8912344dd75c29fbb2021-11-01T00:00:00Zhttps://www.karger.com/Article/FullText/520559https://doaj.org/toc/2296-9705We report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritoneal dialysis (PD) was started but that had to be converted to HD because of pleural effusion due to PD fluid leakage. On the event day, the patient presented a respiratory distress 2 h after the initiation of HD. He developed a sudden onset of dyspnea with hypoxemia, associated with abdominal pain, nausea, and vomiting. He also presented chest pain with arterial hypertension. The pre-pump arterial and post-pump pressures were, respectively, 40 and 100 mm Hg, with no machine alarm. The blood color in the circuit changed and became darker, so HD was stopped immediately without blood restitution, and then a blood workup was obtained, and the patient was treated with oxygen therapy, IV methylprednisolone 40 mg, and IV furosemide 100 mg. Tubing checkup performed after the incident showed a kinked arterial tube which led to the suspicion of acute hemolysis. Blood transfusion was therefore urgently ordered, and the patient was immediately transferred to the intensive care unit (ICU). Artificial ventilation was required for 4 days, with initial massive blood transfusion. A 24-h treatment with extracorporeal cytokine adsorber CytoSorb® was also performed, followed by the regular HD sessions thrice weekly. Evolution was favorable, and the patient was discharged from the ICU 18 days later.Maxime TaghaviLucas JacobsSaleh KaysiMaria do Carmo Filomena MesquitaKarger Publishersarticlehemolysishemodialysisfaulty blood tubing setskinking of bloodlinesDiseases of the genitourinary system. UrologyRC870-923ENCase Reports in Nephrology and Dialysis, Vol 11, Iss 3, Pp 348-354 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hemolysis hemodialysis faulty blood tubing sets kinking of bloodlines Diseases of the genitourinary system. Urology RC870-923
spellingShingle	hemolysis hemodialysis faulty blood tubing sets kinking of bloodlines Diseases of the genitourinary system. Urology RC870-923 Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita Hemolysis in a Patient during Hemodialysis
description	We report a case of hemolysis during a hemodialysis (HD) session in a 71-year-old man. His end-stage kidney disease is secondary to light-chain amyloidosis with renal involvement. Despite immunosuppressive treatment, his renal function continued to decline, and dialysis had to be initiated. Peritoneal dialysis (PD) was started but that had to be converted to HD because of pleural effusion due to PD fluid leakage. On the event day, the patient presented a respiratory distress 2 h after the initiation of HD. He developed a sudden onset of dyspnea with hypoxemia, associated with abdominal pain, nausea, and vomiting. He also presented chest pain with arterial hypertension. The pre-pump arterial and post-pump pressures were, respectively, 40 and 100 mm Hg, with no machine alarm. The blood color in the circuit changed and became darker, so HD was stopped immediately without blood restitution, and then a blood workup was obtained, and the patient was treated with oxygen therapy, IV methylprednisolone 40 mg, and IV furosemide 100 mg. Tubing checkup performed after the incident showed a kinked arterial tube which led to the suspicion of acute hemolysis. Blood transfusion was therefore urgently ordered, and the patient was immediately transferred to the intensive care unit (ICU). Artificial ventilation was required for 4 days, with initial massive blood transfusion. A 24-h treatment with extracorporeal cytokine adsorber CytoSorb® was also performed, followed by the regular HD sessions thrice weekly. Evolution was favorable, and the patient was discharged from the ICU 18 days later.
format	article
author	Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita
author_facet	Maxime Taghavi Lucas Jacobs Saleh Kaysi Maria do Carmo Filomena Mesquita
author_sort	Maxime Taghavi
title	Hemolysis in a Patient during Hemodialysis
title_short	Hemolysis in a Patient during Hemodialysis
title_full	Hemolysis in a Patient during Hemodialysis
title_fullStr	Hemolysis in a Patient during Hemodialysis
title_full_unstemmed	Hemolysis in a Patient during Hemodialysis
title_sort	hemolysis in a patient during hemodialysis
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/a3cbbb31ba7e46b8912344dd75c29fbb
work_keys_str_mv	AT maximetaghavi hemolysisinapatientduringhemodialysis AT lucasjacobs hemolysisinapatientduringhemodialysis AT salehkaysi hemolysisinapatientduringhemodialysis AT mariadocarmofilomenamesquita hemolysisinapatientduringhemodialysis
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Hemolysis in a Patient during Hemodialysis

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