Hypersensitivity to hemodialysis: the United Kingdom experience

A postal survey of all U.K. hemodialysis centers was conducted to investigate the prevalence of hypersensitivity in the first use of disposable dialyzers. A total of 117 patients with 243 separate reactions were identified, suggesting that 1 in 20 to 1 in 50 patients may be susceptible to an anaphylactoid reaction to a new hemodialyzer at some time, while the risk of reaction occurring with any single hemodialysis is approximately 1 in 1,000 to 1 in 5,000. No particular brand or type of hemodialyzer nor any identifiable technique of priming procedure was associated with reactions, but in those few patients who suffered repeated reactions further problems were avoided by increasing the volume of saline in the initial rinse of the hemodialyzer or by changing to another brand of hemodialyzer. Although it is likely that many reactions are unrecognized or unreported, the scale of the problem is larger than many British nephrologists had suspected.