Certified Clinical Hemodialysis Technician (CCHT) Practice Exam

Excessive amounts of chloramines in the dialysate can lead to methemoglobinemia, a condition where hemoglobin is altered such that it cannot bind oxygen efficiently. This can occur because chloramines can oxidize the iron in the hemoglobin from the ferrous (Fe2+) to the ferric (Fe3+) state. In this oxidized state, hemoglobin becomes methemoglobin, which has a reduced ability to transport oxygen throughout the body.

The symptoms of methemoglobinemia may include cyanosis, fatigue, shortness of breath, and in severe cases, it can lead to serious health consequences due to inadequate oxygen supply to tissues. This makes methemoglobinemia a critical concern for patients undergoing dialysis, as their treatment relies heavily on the effective delivery of oxygen to maintain their overall health and wellbeing.

Understanding the implications of chloramine exposure is essential for those in the field of nephrology, as it emphasizes the need for strict quality control measures in dialysate preparation to ensure patient safety.