Dialyzers associated with thrombocytopenia during hemodialysis treatment
Kiaii M. JAMA. 2011;306:1679-1687.
Patients undergoing hemodialysis with electron beam sterilized dialyzers were at significantly increased risk for thrombocytopenia in a cohort study of patients from two Canadian provinces who were treated in 2009 and 2010.
Researchers observed a 50% decrease in the percentage of patients with post-dialysis thrombocytopenia after discontinuing use of the electron beam (e-beam) sterilized dialyzers.
After testing 2,131 patients undergoing hemodialysis, researchers determined that 83% of patients in British Columbia (n=1,706) and all patients in Alberta (n=425) were treated with e-beam sterilized dialyzers. The remaining patients in British Columbia were treated with non–e-beam sterilized dialyzers (n=251).
Researchers found a significant association between thrombocytopenia and type of dialyzer used before all hospitals switched to non–e-beam sterilized dialyzers. That was more evident in patients with previous exposure to non–e-beam sterilized dialyzers. The combination polysulfone and e-beam was statistically significantly associated with post-dialysis thrombocytopenia.
After switching to non–e-beam sterilized dialyzers, researchers observed significant reductions in post-dialysis; 120 patients (6.7%; 95% CI, 5.6-8) had platelet counts of less than 100 X 103/mcL, 167 patients (9.4%; 95% CI, 8.1-10.8) had decreases in platelet counts of more than 15%; and 38 patients (2.1%; 95% CI, 1.5-2.9) met both criteria.
In British Columbia, 2.1% (95% CI, 1.5-2.9) of patients had a post-dialysis platelet count of less than 100 X 103/mcL and a more than 15% decrease in platelet count, down from 7.2% (95% CI, 6-8.6) before the switch. In Alberta, that percentage decreased from 7.3% (95% CI, 5.1-10.3) to 1.6% (95% CI, 0.7-3.4).