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Hemodialysis

Hepatitis C and Hemodialysis 

March 2, 2023 by Dr. Ravi Bhadania

During hemodialysis, the body remains at high risk of getting infected by the hepatitis C virus. HCV infection during the condition of the patient in which he must remain under regular dialysis causes the chances of survival of the patient to diminish. Two main reasons for the increased risk of death of a patient on regular dialysis are liver diseases and cardiovascular disease. If the patient who is on maintenance hemodialysis gets infected by hepatitis C, there is a higher risk of complications to undergoing a transplant in comparison with the patient who is not infected. Therefore, the presence of HCV in dialysis patients may delay the transplant procedure and extend the period for which the patient must stay on dialysis. In this blog, we will learn about certain things associated with hepatitis C and hemodialysis.

What is hemodialysis

When the urine is filtered artificially and not by kidneys, the patient is said to be on hemodialysis. Hemodialysis is done for patients who are suffering from acute kidney failure. It is not a treatment for kidney failure but is only a bridge between the condition of the patient and a kidney transplant. In hemodialysis, a device known as a dialyzer is used outside the body.  The impure blood is circulated into a dialyzer and then put the filtered and clean blood back into the body.

There is always an increased risk of infections during dialysis. The reason for this lies in the fact that oftentimes protocols for the prevention of infection spreading are not completely followed by the providers of the procedure. Cross-contamination or several other factors can lead to the contraction of the hepatitis C virus by the patient undergoing dialysis.

How is hepatitis C infection diagnosed in dialysis patients?

  • The most common method for diagnosing HCV infection in a dialysis patient is enzyme-linked immunosorbent assay (EIA). In this test detection and measurement of antibodies of HCV is determined in the blood. If this test is positive, then other tests are done to know if the virus is still present in the bloodstream
  • The other method to diagnose HCV to be completely sure is the polymerase chain reaction technique. In this method, HCV RNA is found in the blood
  • The next step in diagnosis after the infection is already diagnosed is to determine the type of strain of HCV with which the patient is infected

It is very important for the patients who are to undergo hemodialysis, to be tested for HCV before the procedure and not after. The reason for this is the dialyzing fluid used in the dialyzer may alter the HCV RNA count in the blood.

Treatment for Hepatitis C in dialysis patients

The treatment for HCV infection in dialysis patients was determined by a study in which 100 patients with EGFRs < 30 were given dosages of direct antiviral agents. 80 out of these 100 patients were on dialysis. It was observed that newer direct antiviral agents led to almost 100% cure of Hepatitis C within 12 weeks of treatment.

Therefore, direct antiviral agents appear to be quite effective even in patients on chronic hemodialysis

Prevention of hepatitis C infection during hemodialysis

Following practices can reduce the risk of hepatitis C infection during hemodialysis

  • Washing hands to maintain hygiene
  • Keeping medicines in a different and clean area 
  • Cleaning the fistula with an antiseptic
  • Cleaning the resting area of the patient
  • Disinfecting devices before each use
  • Changing the IV solution for each patient
  • Changing the needles to be used

Conclusion

Determining Hepatitis C in patients who are undergoing Hemodialysis is difficult due to the absence of hepatitis C symptoms in the patients. This leads to the occurrence of liver and heart-related issues in dialysis patients. As the diagnosis of HCV is delayed in dialysis centers, it becomes hard for doctors to target the HCV with proper treatment at the proper time. In consequence, HCV infection leads to the worsening of a dialysis patient. In certain cases, becoming a factor of mortality for them.

From the above content, diagnosis and prevention of hepatitis C are the most important things to deal with the Hepatitis C-related mortality of patients on dialysis. As the awareness about this subject matter is spreading with proper studies and surveys, certain effective measures are taken in dialysis centers these days. Some examples of these measures are always diagnosing a patient before performing hemodialysis on them, and strictly following the prevention measures.

With these measures taken, the data is witness to the fact that the number of patients on hemodialysis with Hepatitis C infections is continually being reduced worldwide.

At Alfa Kidney Care, it is made certain that all the precautionary measures are followed with utmost seriousness.

For more information Contact rpbnephro@gmail.com

Tags: dialysis centersHemodialysisHepatitis CTreatment Hepatitis C
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