Hemodialysis Emergencies: Core Curriculum 2021

Area of Science:

• Nephrology
• Internal Medicine

Background:

• Maintenance hemodialysis (HD) has become a standard treatment for kidney failure since 1962.
• Despite its routine nature, HD is a complex procedure with potential life-threatening complications.

Purpose of the Study:

• To review the pathogenesis, management, and prevention of 9 critical hemodialysis emergencies.
• To equip practicing nephrologists with knowledge to recognize and manage these complications.

Main Methods:

• Review of existing literature and clinical protocols related to hemodialysis emergencies.
• Compilation of information on the etiology, clinical presentation, and treatment strategies for specific complications.

Main Results:

• Identified 9 key hemodialysis emergencies: dialyzer reactions, dialysis disequilibrium syndrome, uremic/dialysis-associated pericarditis, air embolism, venous needle dislodgement, vascular access hemorrhage, hemolysis, dialysis water contamination, and arrhythmia episodes.
• Detailed the pathogenesis, management, and prevention strategies for each emergency.

Conclusions:

• Nephrologists must be knowledgeable about recognizing, managing, and preventing serious hemodialysis complications.
• Adherence to modern HD technology, water treatment, and strict monitoring protocols enhances patient safety.