0
Letters |

Electron-Beam Sterilized Hemodialyzers and Thrombocytopenia

Scott Bieber, DO; Suhail Ahmad, MD
JAMA. 2012;307(7):665-666. doi:10.1001/jama.2012.144.
Text Size: A A A
Published online

Extract

To the Editor: Dr Kiaii and colleagues1 described index cases of thrombocytopenia occurring during hemodialysis that led to an extensive investigation, culminating in the finding of an association between the use of electron-beam sterilized dialyzers and thrombocytopenia. We have some concerns and urge caution when interpreting the conclusions.

The hemodialysis process has been known to cause a decrease in platelet counts for a variety of reasons, including the effects of the dialyzer membrane, anticoagulation, clot formation and consumption of platelets, and bioincompatibility of components such as blood tubing and dialysate. Because the comparisons used historical controls over a period of several months, it is important to know whether any other changes in hemodialysis practices occurred during this period. Changes in vascular access from catheter or graft to fistula, dialysate composition from higher acetate to lower acetate, dialysate purity by a change in water treatment, use of a dialysate filter, or the dose or supply of heparin could significantly alter the platelet count. Thrombocytopenia in patients receiving hemodialysis may be more prevalent in those who receive hemodialysis through a catheter, related to the inflammatory milieu caused by the foreign body, chronic infection, or the anticoagulant used.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();