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

Table 2 Details of renal replacement therapy conducted during the patient’s hospital stay. Includes renal replacement therapy modality, cleansing solution, anticoagulation agent and catheter locking solutions used

Session	Location	Modality	Cleansing solution	Dialyser	Anticoagulation	Catheter locking solution	Change of exit site dressing performed	Reaction
1	Inpatient Dialysis Center	HD	Chlorhexidine	FMC F7 HPS	None	Citrate	Yes, to Biopatch®	Hypotension. IV Saline given
2	Intensive Care Unit	CRRT	Chlorhexidine	Gambro Prismaflex	Heparin	Citrate	No	Nil
3	Intensive Care Unit	HD	Chlorhexidine	FMC F7 HPS	Heparin	Citrate	No	Nil
4	Inpatient Dialysis Center	HD	Chlorhexidine	FMC F7 HPS	Heparin	Citrate	No	Hypotension, Hypoxia, Urticaria. IV Saline given. IV Dopamine infusion started.
5	Intensive Care Unit	HD	Chlorhexidine	FMC F7 HPS	Heparin	Citrate	No	Nil
6	Inpatient Dialysis Center	HD	Chlorhexidine	FMC F7 HPS	None	Citrate	Yes, to Biopatch®	Hypotension, Hypoxia, Urticaria before dialysis catheter was connected to machine. IM Adrenaline, IV Diphenhydramine, IV Hydrocortisone, IV Saline given
7	Intensive Care Unit	IsoUF+HD	Chlorhexidine	FMC F7 HPS	Heparin	Citrate	No	Nil
8	Intensive Care Unit	IsoUF+HD	Chlorhexidine	FMC F7 HPS	Heparin	Citrate	Yes	Nil
9	General Ward (Single room)	HD	Povidone Iodine	FMC F7 HPS	Heparin	Citrate	Yes	Nil
10	General Ward (Single room)	HD	Povidone Iodine	FMC F7 HPS	Heparin	Citrate	Yes	Nil
11	Inpatient Dialysis Center	HD	Povidone Iodine	FMC F7 HPS	Heparin	Citrate	Yes	Nil
12	Inpatient Dialysis Centre	HD	Povidone Iodine	FMC F7 HPS	Heparin	Citrate	Yes	Nil

Abbreviations: HD Hemodialysis, CRRT Continuous renal replacement therapy, IsoUF Isolated ultrafiltration. Biopatch®: a polyurethane foam disc impregnated with chlorhexidine gluconate

ISSN: 1471-2369