Dialyzer-associated thrombocytopenia: Case report and brief review of the literature

We report the case of an 81-year-old man with end-stage kidney disease (ESKD) who was admitted to the intensive care unit with severe gastroenteritis and hypovolemic shock. During hospitalization, he underwent hemodialysis via a subclavian catheter using the NxStage system, which was followed by a progressive daily decline in platelet count. Despite platelet transfusions and corticosteroid therapy, thrombocytopenia persisted. A comprehensive evaluation excluded secondary causes, such as infection, drug-induced thrombocytopenia, and disseminated intravascular coagulation. Upon switching to a different hemodialysis system utilizing the Diacap 18NR filter (manufacturer: B. Braun), platelet counts improved significantly over the following sessions. This case highlights the importance of recognizing dialyzer-associated thrombocytopenia and demonstrates that prompt identification and substitution of the implicated membrane can result in rapid hematologic recovery and improved patient outcomes.