Acute hypersensitivity reactions during hemodialysis: a case series of end-stage renal disease patients

Shaheer Ahmad Dar; Fatima Shams; Muhammad Asim Agha; Amna Shams; Muhammad Umar; Ahmad Shabbir

doi:10.18203/issn.2454-2156.IntJSciRep20252193

Authors

Shaheer Ahmad Dar Poonch Medical College, Right Foundation Dialysis Centre, Rawalakot, Pakistan
Fatima Shams Nishtar Medical University, Multan, Pakistan
Muhammad Asim Agha Nishtar Medical University, Multan, Pakistan
Amna Shams CMH Multan Institute of Medical Sciences, Pakistan
Muhammad Umar Khairpur Medical College, Khairpur Mir's, Pakistan
Ahmad Shabbir Nishtar Medical University, Multan, Pakistan

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20252193

Keywords:

Hemodialysis, Acute hypersensitivity reaction, End-stage renal disease, Dialysate contamination, Dialyzer membrane

Abstract

Hypersensitivity reactions during hemodialysis (HD) are rare but potentially life-threatening events. They are often attributed to dialyzer membranes, sterilization agents, or dialysis solutions. This case series highlights acute hypersensitivity episodes in three HD patients at the same center. This report presents a case series of three patients with end-stage renal disease (ESRD) developed symptoms such as back pain, body pain, and shivering approximately 40-45 minutes into their HD sessions. Rapid intervention with hydrocortisone and pheniramine resolved the symptoms. Following the disinfection of equipment and preparation of fresh bicarbonate solutions, HD was resumed uneventfully. Similar timing and symptomatology in multiple patients suggest potential triggers related to dialysate composition, bacterial endotoxins, or other contaminants. This underscores the need for stringent quality control and monitoring in dialysis facilities. Timely recognition and management of hypersensitivity reactions during HD are crucial for patient safety. Further investigation is warranted to identify specific triggers and implement preventive measures.

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