Normal red cell survival is possible in dialyzed patients. Certain substances like copper and nitrate nitrite induce hemolysis if present in the dialysate. The authors identified another and probably a more frequent cause for hemolysis in dialyzed patients: chloramines. These compounds are becoming more frequent in tap water as large water plants increasingly use chloramines rather than chlorine as bactericidal agents in tap water; they pass reverse osmosis membranes easily; directly induce oxidant damage to red cells with methemoglobin formation; damage the hexosemonophosphate shunt (HMPS) with which red cells defend themselves against oxidant damage; consequently induce hemolysis and short red cell survival time; sensitize the patients to oxidant drugs like primaquine, sulfonamides, etc.; can be removed by charcoal filtration, boiling, or vacuum treatment; and are most expediently neutralized by the addition of ascorbic acid in physiological amounts to the dialysate.
|Original language||English (US)|
|Number of pages||7|
|State||Published - Jan 1 1974|