ESPN 51th Annual Meeting

ESPN 2018


 
Eosinophilia in pediatric hemodialysis (HD) patients
ARMIER HéLèNE 1 DELBET JEAN-DANIEL 1 ULINSKI TIM 1

1- HôPITAL TROUSSEAU
 
Introduction:

 Eosinophilia has been documented in hemodialysis patients as a consequence of the dialysis equipment. Eosinophilia from any other cause has also been reported to cause life-threatening reactions in patients undergoing hemodialysis due to the release of interleukins and eosinophil peroxidase by degranulation from eosinophils.

Material and methods:

 We analyzed retrospectively the last 30 (12 girls) consecutive pediatric hemodialysis patients in our HD unit. At the time of eosinophilia discovery mean age was 9 (2.3 – 17) years. ESRD was due to CAKUT (N=12), Glomerular diseases (N=10), Lupus nephritis (N=2), syndromic diseases (N=4), and cystic renal diseases (N=2).

Results:

 Twenty-two (73%) had at least one blood sample with eosinophilia while being treated on chronic hemodialysis for a total duration of 0.25 - 2.8 years. Eosinophilia lasted from 1 to 27 months. Maximum eosinophil count was 0.8 (0.3 – 1.9) x 109/L (N: <0.2 109/L); Eight patients had ≥1 x 109/L. There were no specific correlation between specific dialyzers or blood lines with eosinophil count, but in 5 patients changing the HD equipment resulted in rapid normalization of eosinophil count. There were no anomalies in echocardiography findings apart from left ventricular hypertrophy (LVH) in one third of patients. LVH was not correlated with eosinophil count.

Conclusions:

 Eosinophilia has not yet been described in pediatric patients on HD. Potential clinical consequences, such as intolerance reactions at HD session onset might be avoidable by monitoring eosinophils count and adapting HD equipment accordingly.