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Presumptive nickel dermatitis from hemodialysis
Archives of Dermatology
|August 1, 1984
Summary
Patients with nickel sensitivity may react to nickel exposure during hemodialysis. Stainless steel fittings can leach nickel into the bloodstream, increasing plasma nickel levels significantly.
Area of Science:
- Nephrology
- Toxicology
- Materials Science
Background:
- Nickel hypersensitivity is a common contact allergy.
- Hemodialysis involves blood contact with medical devices and solutions.
Observation:
- A patient with known nickel sensitivity developed hypersensitivity symptoms during hemodialysis.
- The patient was exposed to a 316 stainless-steel fitting in contact with 6N hydrochloride during dialysis.
Findings:
- In vitro experiments confirmed nickel can be dialyzed into blood from stainless steel.
- Plasma nickel levels increased by 89% post-dialysis compared to the dialysate.
- This increase is attributed to nickel's affinity for plasma proteins.
Implications:
- Nickel leaching from medical devices is a potential risk for hypersensitive patients undergoing hemodialysis.
- Careful selection of materials for hemodialysis equipment is crucial.
- Further research is needed to assess the prevalence and clinical significance of nickel exposure during dialysis.