Anaphylactoid reactions during hemodialysis on AN69 membranes in patients receiving ACE inhibitors.
We report five life-threatening anaphylactoid reactions occurring within the very first minutes of hemodialysis on polyacrylonitrile (AN69) capillary dialyzers in three patients receiving ACE inhibitors. Such reactions were not observed either in patients treated with ACE inhibitors but dialyzed on other membranes (N = 9), nor in patients on AN69 who did not receive ACE inhibitors (N = 19). These anaphylactoid reactions could be due to bradykinin accumulation, as a result of both increased synthesis--by interaction of blood with the AN69 polymer--and catabolism blockade by ACE inhibitors.
Tielemans
C
C
Department of Nephrology, Dialysis, and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Madhoun
P
P
Lenaers
M
M
Schandene
L
L
Goldman
M
M
Vanherweghem
J L
JL
D000180:Acrylic Resins; D000181:Acrylonitrile / Q000031:analogs & derivatives*; D000368:Aged; D000707:Anaphylaxis / Q000209:etiology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis
D000180:Acrylic Resins; D000806:Angiotensin-Converting Enzyme Inhibitors; D008567:Membranes, Artificial; C016892:AN-69; D000181:Acrylonitrile