Presumptive nickel dermatitis from hemodialysis

Presumptive cutaneous hypersensitivity to nickel administered intravenously during hemodialysis was observed in a patient with nickel sensitivity. The source of the nickel was a 316 stainless-steel fitting that came in contact with 6N hydrochloride during dialysis. An in vitro experiment was performed to demonstrate the ability of nickel to be dialyzed into blood through a standard hemodialysis system. A plasma nickel level 89% higher than that of the original dialysate was achieved with a single cycle of dialysis. This is consistent with the plasma protein binding of nickel.