Emergencies - clinical

Dialysis machine proportioning problems can result in severe serum electrolyte abnormalities. Some of these emergencies include:

• High or low serum sodium, potassium, calcium or magnesium
• High or low plasma osmolarity due to hyper- or hypo- osmolar dialysate

Clinical emergencies can occur significant levels of contaminants are in the dialysate:

• Copper or cupraphane may be released from heating element or dialyzer and can cause severe hemolysis
• Chloramines and nitrates can cause severe hemolysis
• Fluoride can cause severe pruritis, nausea, and ventricular tachicardia or fatal ventricular fibrillation
• Aluminium can cause bone disease, anemia and fatal progressive neurologic deterioration commonly known as dialysis encelopathy syndrome
• Lead, copper, zinc and aluminium can leach from metal pipes and cause anemia