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Dialysis hypersensitivity: a fading problem?

C De Filippi1, V Piazza, E Efficace

  • 1Dermatological Clinic, University of Pavia, Italy.

Blood Purification
|May 8, 1998
PubMed
Summary
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Patients on hemodialysis show normal immunoglobulin E (IgE) levels unless they have allergies. Uremia does not affect IgE reactivity, suggesting fewer hypersensitivity reactions during dialysis sessions.

Area of Science:

  • Nephrology
  • Immunology
  • Allergy and Immunology

Background:

  • Allergic-type reactions are common in hemodialysis patients, often linked to ethylene oxide (ETO).
  • Dialysis patients may exhibit elevated immunoglobulin E (IgE) levels compared to the general population.

Purpose of the Study:

  • To investigate IgE levels and reactivity in hemodialysis patients compared to healthy and predialysis controls.
  • To assess the relationship between IgE, ethylene oxide (ETO) antibodies, and hypersensitivity reactions during hemodialysis.

Main Methods:

  • Compared IgE values in 126 dialysis patients against healthy and predialysis control groups.
  • Monitored anaphylactic symptoms and tested for IgE antibodies against ethylene oxide (ETO) over a 4-year period.

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Main Results:

  • Nonallergic dialysis patients had similar IgE levels to healthy and predialysis controls.
  • Allergic dialysis patients showed significantly higher IgE levels.
  • Only 3 patients experienced anaphylactic symptoms, none with detectable ETO antibodies; 6 symptom-free patients had ETO IgE antibodies.

Conclusions:

  • Uremia does not appear to alter IgE reactivity in predialysis or long-term dialysis patients.
  • Hypersensitivity reactions during hemodialysis may occur less frequently than previously suggested.
  • The presence of IgE antibodies against ETO does not always correlate with clinical hypersensitivity symptoms during dialysis.