Dialysis, infections and hepatitis

GLENN ELLIS | 5/21/2018, 3:48 p.m.
By definition, hemodialysis is pumping a patient’s blood through a filtration device to remove toxins that failing kidneys can no ...
Rosie Reed receives dialysis treatment – File photo Wiley Price

Strategies for Well-Being

By definition, hemodialysis is pumping a patient’s blood through a filtration device to remove toxins that failing kidneys can no longer handle, and then pumping it back into the body.

Kidney failure life expectancy depends on many variables, some of which you can control, and others that you cannot control: age, gender, genes, race, diet, lifestyle choices, what caused your condition [etiology], the type of treatment you choose, etc.

It should be noted that I am discussing life expectancy in relationship to kidney failure. This means that the kidneys are now functioning at or below 15 percent – also termed as End-Stage-Kidney-Failure or Stage 5 Kidney Failure. It is important to make this distinction, because the life expectancy severely drops once at this level.

Dialysis treatment - either in a hospital, a dialysis unit or at home - is needed when the kidneys cannot filter wastes from the body sufficiently. Each year, about 37,000 dialysis patients in the United States develop potentially deadly bloodstream infections associated with their treatment, the CDC reported.

According to a new CDC emergency health advisory, there have been an increasing number of reports of the transmission of Hepatitis C, or HCV, in patients undergoing dialysis. The number of cases appears to be small, but it should be zero, because HCV can only be transmitted through contaminated blood or blood products.

What has to be involved for this to happen? The only blood that the patient should be receiving or exposed to during dialysis is his or her own. So, transmission of the virus can only come from the patient being exposed to the blood of someone who is already infected: in other words, through poor hygiene or inadequate sanitary practices, sloppiness or improperly sterilized equipment

The high risk of infections in dialysis patients is due to a number of factors including the close distance of dialysis patients to each other, the fast patient turnover between dialysis sessions, and health of the person receiving dialysis. The most common form of treatment for end-stage renal disease [ESRD, or kidney failure] is hemodialysis. If your medical facility does not follow guidelines for infection control in the right way, it is possible to get hepatitis C from doing hemodialysis.

Hepatitis C virus – or HCV – remains common in patients undergoing regular dialysis and is an important cause of liver disease in this population both during dialysis and after a kidney transplant.

Hepatitis C is a viral infection that causes inflammation of the liver and can lead to serious liver damage. It spreads through contaminated blood, most often through intravenous drug use. At least 3.2 million Americans are living with chronic hepatitis C infection and most don’t know it. And with the ongoing opioid epidemic, the numbers of hepatitis C-infected donor organs may be growing as well, experts have said.

Many dialysis patients have other health conditions and/or a weakened immune system, which can increase susceptibility to infections, especially when infection prevention practices are not strictly followed by dialysis staff. These health conditions often result in dialysis patients having frequent admissions to hospitals, which expose them to antibiotic therapy and drug-resistant bacteria. In the U.S., hemodialysis patients are several times more likely to be infected with hepatitis C, and in some countries, up to half of dialysis patients are infected.