Acute hemolysis due to profound hypo-osmolality. A complication of hemodialysis

Acute hemolysis in maintenance hemodialysis patients is not a rare occurrence. Significant hemolysis is life-threatening and may be unrecognized because of nonspecific symptomatology. This paper reports observation of a severe hemolytic episode in a hemodialysis patient. The hemolysis was associated with a sudden drop in serum osmolality and profound hyponatremia, resulting from accidental dialysis against deionized water. Recognizing the condition and treating it promptly by dialysis with physiological dialysate are essential for patient survival.