Iatrogenic Errors in Hemodialysis Practices

Abstract

Chronic kidney disease (CKD) and its evolution to end-stage kidney disease (ESKD) are a rapidly increasing global health and healthcare burden . With more than 850 million people suffering from CKD, acute kidney injury, and renal replacement therapy (RRT), the need for hemodialysis (HD) continues to rise worldwide. However, although the safety profile of hemodialysis has been satisfactory over the years, various errors such as dialysis machine errors, dialysate composition errors, and errors in dialysis techniques have been reported, and the treatment has been associated with the highest mortality rates, followed by kidney transplantation and peritoneal dialysis. Consideration of some of these errors could improve safety by facilitating the implementation of preventive measures. The aim of this study was to highpoint some of the important iatrogenic errors encountered during hemodialysis. This review found that common iatrogenic complications during hemodialysis include iatrogenic hypernatremia, iatrogenic iron overload, iatrogenic pseudoaneurysm, iatrogenic cerebral air embolism, iatrogenic infective endocarditis (IE) in Chronic Hemodialysis (CHD) patients, and major bleeding. Adverse effects associated with these complications include interdialytic weight gains, hypertension, cardiovascular events, local pain, neuropathy, distal embolization, and death.