What Dialysis Patients Don't Need: Incompetence, Hepatitis C

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Screen Shot 2016-01-27 at 4.48.00 PMBy definition, people who are undergoing hemodialysis 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 are gravely ill.

The process is not only exhausting three visits per week to a medical facility, each taking about four hours but it can only do so much. Dialysis is an effective short- and medium-term treatment for patients with kidney failure, but it does not replace normal functioning kidneys. Not even close.

Within five years of beginning dialysis, 65 percent of patients will die. The only alternative is a new kidney, which is not only difficult to get (the number of kidneys needed is far greater than those that are available), but also requires that recipients take anti-rejection immunosuppressants for life.

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A patient undergoing hemodialysis (Source: Wikipedia)

If this sounds horrible, imagine what it must be life for patients who are enduring this treatment, only to be unnecessarily infected by a dangerous pathogen like Hepatitis C.

Yet, this has been happening.

According to a new CDC emergency health advisory, there has 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 level of incompetence 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. This is inexcusable.

The CDC knows it, as we all do. Their advisory to dialysis providers and facilities (my italics) is as follows:

  • (1) Assess current infection control practices and environmental cleaning and disinfection practices within the facility to ensure adherence to infection control standards
  • (2) Address any gaps identified by the assessments
  • (3) Screen patients for HCV, following CDC guidelines, to detect infections, determine treatment potential, and halt secondary transmission
  • (4) Promptly report all acute HCV infections to the state or local health department.

HCV (unlike HIV) is almost exclusively transmitted by blood, and there have been reports of infection from colonoscopies, endoscopies, and possibly tattoos. But dialysis?

Finally, an example of one of life's awful ironies: Although Hepatitis C is now curable because of new miracle drugs, like Sovaldi, one of the warnings for the drug cautions people with compromised kidney function (!).

I don't even know what to say.