Low Platelet Counts Linked to E-Beam Dialyzers
Use of electron beam (e-beam) sterilized dialyzers is associated with an increased risk of thrombocytopenia, according to a Canadian study.
Among 1,706 hemodialysis patients using e-beam sterilized dialyzers, 7.2% in British Columbia and 7.3% in Alberta had significant post-dialysis thrombocytopenia (post-dialysis platelet count below 100 × 103/µL and a post-dialysis platelet count decrease of greater than 15%).
After adjusting for patient history, use of an e-beam sterilized dialyzer was associated with a 2.5 times increased odds of thrombocytopenia compared with not using these dialyzers.
Together with previous studies, the findings suggest that the risk of thrombocytopenia can be reduced by switching to another type of dialyzer.
Mercedeh Kiaii, MD, FRCPC, and colleagues at the University of British Columbia in Vancouver, published their findings in The Journal of the American Medical Association (2011;306:1707-1708).
The researchers noted that reactions such as thrombocytopenia can still occur with current dialyzer technology, and “these reactions may be overlooked with current routine predialysis blood work.” They recommended incorporating post-dialysis blood counts to routine blood work in order to identify dialyzer-associated adverse effects.
While the investigators stated that e-beam sterilization has yet to be thoroughly evaluated for its effect on platelets, they noted the possibility that “exposure to e-beam radiation may change membrane integrity, structure, or physical properties of the dialyzer.” E-beam radiation may also create intermediary substances that could affect platelet activation or aggregation, but additional evidence would be necessary.