Hemodialysis

Anaphylaxis and anaphylactoid reactions during hemodialysis have been attributed to a number of different factors. Ethylene oxide used for sterilization can produce an IgE-mediated event. Other reactions have been related to the procedure used in processing the hemodialyzer. The type of hemodialysis membrane can be important. Severe reactions have been reported with the use of hollow-fiber membranes made of cuprammonium cellulose. The use of angiotensin-converting enzyme(ACE) inhibitors during dialysis seems to predispose to anaphylactoid events. When a patient experiences anaphylaxis during hemodialysis, the type of membrane should be changed, no reprocessed membrane should be used, and ACE inhibitors and p-blockers should be discontinued if possible.

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