Chlorhexidine – a commonly used but often neglected culprit of dialysis associated anaphylactic reactions (case report)

Table 1 Details of renal replacement therapy conducted during the patient’s hospital stay. Includes cleansing solution, anticoagulation agent and catheter locking solutions used

Session	Location	Modality	Cleansing Solution	Dialyser	Anticoagulation	Catheter Locking Agent	Reaction
1	Inpatient Dialysis Center	LED (Low Efficiency Dialysis)	Chlorhexidine	FMC, F6HPS	None	Heparin	Nil
2	Inpatient Dialysis Center	LED	Chlorhexidine	FMC, F6HPS	Heparin	Heparin	Pruritis
3	Inpatient Dialysis Center	LED	Chlorhexidine	FMC, F6HPS	None	Citrate	Shortness of breath and flushing after 2 min. Dialysis terminated. IV Hydrocortisone and IV Diphenhydramine given
4	Inpatient Dialysis Center	LED	Chlorhexidine	Nipro Sureflux 19 E	None	Citrate	Nil
5	Inpatient Dialysis Center	HD	Chlorhexidine	Nipro Sureflux 19 E	Heparin	Citrate	Nil
6	Inpatient Dialysis Center	IsoUF	Chlorhexidine	Nipro Sureflux 19 E	None	Citrate	Nil
7	Inpatient Dialysis Center	HD	Chlorhexidine	Nipro Sureflux 19 E	None	Heparin	Nil
8	Inpatient Dialysis Center	HD	Chlorhexidine	Nipro Sureflux 19 E	Heparin	Heparin	Nil
9	Inpatient Dialysis Center	IsoUF	Chlorhexidine	Nipro Sureflux 19 E	Heparin	Heparin	7 min into dialysis – generalised erythema / pruritis / angioedema. No stridor / wheeze. Blood pressure remained within normal range. Dialysis was terminated. IV Hydrocortisone and IV Diphenhydramine given

ISSN: 1471-2369