Pathological perspective reveals a novel hemodialyzer reaction: a case report

Area of Science:

• Nephrology
• Hematology
• Biomedical Engineering

Background:

• Red clots are common in hemodialysis (HD).
• Recurrent yellowish-white matter in the venous blood pot is a rare HD complication.
• This case involved a 69-year-old male patient with severe anemia.

Observation:

• The patient presented with recurrent yellowish-white matter in the HD venous pot and red clots in the dialyzer.
• Microscopic examination showed neutrophil aggregates and fibrin.
• The condition recurred despite increased low molecular weight heparin dosage.

Findings:

• Switching the dialysis filter completely resolved the yellowish-white matter formation.
• The yellowish-white matter, clotting, and severe anemia were preventable by changing the dialyzer type.
• No pro-thrombotic risk factors were identified in the patient.

Implications:

• Changing the dialyzer type can prevent this rare dialyzer reaction.
• Early identification and awareness of this reaction are crucial for managing hemodialysis patients.
• This case underscores the importance of considering dialyzer-specific reactions in unexplained clotting and anemia during HD.