Hemodialysis in Methemoglobinemia, a friend or foe? A Case Report

Methemoglobinemia is a potentially fatal illness in which circulating levels of methemoglobin in the blood surpasses the usual physiological level decreases hemoglobin's ability to transport oxygen by shifting the oxygen-dissociation curve to the left, limiting oxygen unloading to tissue and contributing to functional hypoxia.1 Acquired causes are more prevalent as compared to congenital and arises from exposure to chemicals that oxidizes hemoglobin either directly or indirectly.2 Most reports of adult methemoglobinemia are related to medication overdoses from local anesthetics. Hemodialysis is one of the researched causes of methemoglobinemia, even though it is not often reported.3 Removing the causative substances and providing supportive care are the cornerstones of methemoglobinemia treatment. Although it is uncommon these days, physicians should be aware of the risks of methemoglobinemia during prolonged hemodialysis as well as the complications that can result from contamination of the dialysis water