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Dialyser Membrane Rupture — ESENeph MCQ

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ModerateHaemodialysisDialyser Membrane RuptureESENeph

A 72-year-old man on haemodialysis develops chest pain during a session. His BP is 85/50 mmHg and he feels cold and clammy. The dialysis machine alarms for a venous pressure drop. Blood is noted in the dialysate (pink/red discolouration). What has occurred?

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Correct answer: E — Dialyser membrane rupture (blood leak)

Pink or red discolouration of the dialysate indicates blood leaking across the dialyser membrane – a dialyser membrane rupture. This is a medical emergency as it can cause blood loss and haemolysis. Management: immediately clamp the blood lines, DO NOT return the blood to the patient (risk of contaminated blood from the dialysate side), discard the circuit, and assess the patient haemodynamically. A new dialyser should be used if dialysis needs to continue.

Reference: ERA-EDTA 2019 – HD Safety; KDOQI 2015 – HD Adequacy