Patient exposure to chloramines during the hemodialysis treatment may cause

• A. Nausea
• B. Hemolysis
• C. Hypertension
• D. Fever

Answer: (B)

Chloramines in dialysate act as oxidants that can damage red blood cells when they enter the bloodstream during dialysis. This oxidative stress leads to hemolysis, the destruction of red blood cells, making it the most likely outcome of chloramine exposure in the dialysis circuit. Nausea, fever, and hypertension aren’t specifically linked to chloramine exposure—the fever risk is more tied to dialysate endotoxins, and the others are not characteristic effects. Proper water treatment and dechlorination are essential to prevent this complication.