Hydroxycobalamin-induced pigmented effluent during dialysis

A 51-year-old female patient with end-stage renal disease required continuous renal replacement therapy after successful treatment with hydroxycobalamin for vasoplegic syndrome after cardiac surgery. Multiple attempts at intermittent hemodialysis were technically problematic and unsafe because hydroxycobalamin triggered the blood leak detector on the 2008K Hemodialysis Machine (Fresenius Medical Care, Bad Homburg, Germany; Figure 1). Hemolysis...