Conversion to non-e-beam sterilized dialyzers lowers postdialysis thrombocytopenia risk
TUESDAY, Oct. 18 (HealthDay News) -- Use of electron-beam (e-beam) sterilized hemodialysis membranes increases the risk of significant thrombocytopenia, according to a study published in the Oct. 19 issue of the Journal of the American Medical Association.
Mercedeh Kiaii, M.D., from the University of British Columbia in Vancouver, Canada, and colleagues investigated the prevalence and etiology of thrombocytopenia in patients who underwent hemodialysis in British Columbia and Alberta between April 2009 and November 2010. Patient, laboratory, and dialyzer data prior to switching to e-beam sterilized dialyzers were analyzed, and predialysis and postdialysis platelet counts were measured before and after conversion to non-e-beam sterilized dialyzers. Significant thrombocytopenia, defined as the combination of a postdialysis platelet count of less than 100×10³/µL and a postdialysis platelet count decrease of more than 15 percent, was measured.
The investigators found that 1,411 and 425 patients from the British Columbia and Alberta cohorts, respectively, underwent hemodialysis with e-beam sterilized dialyzers, with 123 and 31 patients, respectively, meeting both criteria for significant thrombocytopenia. After adjusting for patient and dialysis history characteristics, use of an e-beam sterilized dialyzer significantly increased the odds for significant thrombocytopenia (odds ratio [OR], 2.52). Postdialysis thrombocytopenia was significantly reduced among 1,784 patients following conversion to non-e-beam dialyzers, with a total of 38 patients meeting both criteria. The odds of significant thrombocytopenia increased with the use of e-beam sterilized dialyzers after using generalized estimating equation modeling for repeated data with binary outcome, and after adjustment for patient characteristics (OR, 3.57).
"The use of e-beam sterilized dialyzers was associated with significant thrombocytopenia following dialysis," the authors write.
Two authors disclosed financial ties to Gambro, a biotechnology company that makes hemodialysis equipment.
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