Anti-Nform antibody in hemodialysis patients.
The anti-Nform antibody is produced by dialysis patients following reuse of dialyzers sterilized with formaldehyde and it has been implicated as a cause of hemolytic anemia. Formaldehyde is one of the common disinfectants used for reprocessing capillary hemodialyzers. The safety of formaldehyde and the clinical significance of anti-Nform antibody need further evaluation. Amongst 45 patients practising dialyzer reuse, anti-Nform antibody was detected in 5 (11.1%), but not amongst 111 patients not reusing their dialyzer (p < 0.005). The presence of anti-Nform was not related to the sex, or duration of dialysis with positive anti-Nform antibody. Direct Coombs' test was positive amongst 80% of all tested patients with anti-Nform antibody, and in 38% of patients reusing dialyzers but without anti-Nform antibody. No tests of hemolysis (including direct Coombs' test) discriminated between anti-Nform antibody-positive and -negative patients, nor between anti-Nform antibody patients with and without overt hemolysis. The best diagnostic test for hemolysis in anti-Nform antibody-positive patients was hematocrit rise after cessation of dialyzer reuse. It appears that despite the induction of anti-Nform antibody, hemolysis is rarely a serious consequence of dialyzer reuse.
Ng
Y Y
YY
Division of Nephrology, Veterans General Hospital, Taipei, Taiwan, ROC.
Chow
M P
MP
Wu
S C
SC
Lyou
J Y
JY
Harris
D C
DC
Huang
T P
TP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000097:blood / Q000209:etiology / Q000276:immunology; D016009:Chi-Square Distribution; D004202:Disinfectants / Q000009:adverse effects; D005260:Female; D005557:Formaldehyde / Q000009:adverse effects; D006461:Hemolysis; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000276:immunology / Q000628:therapy*; D008951:MNSs Blood-Group System / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*
D004202:Disinfectants; D007518:Isoantibodies; D008951:MNSs Blood-Group System; D005557:Formaldehyde