Key J, Nahmias M, Acchiardo S
Am J Kidney Dis. 1983 May;2(6):664-6. doi: 10.1016/s0272-6386(83)80050-x.
Forty-five patients who have been maintained on hemodialysis using a regenerated cellulose hollow fiber artificial kidney (HFAK) were dialyzed on a cuprophan HFAK for the first time. Three black patients (6.6%), one male and two females, ages 43-61, who had been stable on hemodialysis for 30-88 months developed hypersensitivity reactions. The recommended setup procedure was carefully followed. Within seconds in 1 patient and within 10-16 minutes in the remaining two, respiratory distress, urticaria, pruritus, hypertension/hypotension, and facial edema developed. Dialysis was discontinued immediately. They were treated with oxygen, epinephrine, and diphenhydramine. Two patients received IPPB treatments and one received IV methyl-prednisolone. After allowing 10-15 minutes for stabilization, the dialysis was resumed on a non-cuprophan HFAK. Patients were discharged with no sequelae. The cause of the hypersensitivity reaction is unknown. It could be due to substances used in the sterilization procedure, to the membrane itself, or to substances that leach out of the potting compound or membrane. Hypersensitivity reaction during hemodialysis has been reported to be very severe or even fatal. Personnel delivering direct patient care should be aware of the symptoms and react quickly with proper treatment. Patients suspected to have this reaction should be changed to a dialyzer without a cuprophan membrane.
45名一直使用再生纤维素中空纤维人工肾（HFAK）进行血液透析的患者首次使用铜仿膜中空纤维人工肾进行透析。3名黑人患者（6.6%），1名男性和2名女性，年龄在43 - 61岁之间，在血液透析30 - 88个月病情稳定后出现了过敏反应。严格遵循了推荐的设置程序。1名患者在数秒内，另外两名患者在10 - 16分钟内出现了呼吸窘迫、荨麻疹、瘙痒、高血压/低血压和面部水肿。立即停止透析。他们接受了吸氧、肾上腺素和苯海拉明治疗。两名患者接受了间歇正压通气治疗，一名患者接受了静脉注射甲基强的松龙治疗。在给予10 - 15分钟使其病情稳定后，在非铜仿膜中空纤维人工肾继续进行透析。患者出院时无后遗症。过敏反应的原因不明。可能是由于灭菌过程中使用的物质、膜本身，或者是从灌封化合物或膜中渗出的物质。据报道，血液透析期间的过敏反应非常严重甚至致命。提供直接患者护理的人员应了解症状并迅速做出适当治疗反应。怀疑有这种反应的患者应更换为无铜仿膜的透析器。
