Hepatitis C and hemodialysis

Hemodialysis (also known as dialysis) is a process that uses a machine to clean your blood. Dialysis does some of the work that your kidneys did when they were healthy. During a hemodialysis treatment:

1. Your blood travels through tubes from your body into the dialysis machine.
2. While your blood is in the machine, it goes through a filter called a dialyzer, which removes waste and extra fluid.
3. Once it has been cleaned, your blood travels through tubes from the dialysis machine back into your body. 

When you are doing dialysis, it is also common to be given medicines orally (by mouth) or by injection into your bloodstream. You may also have tests done, which can involve a blood draw.

Hepatitis C in dialysis centers

The hepatitis C virus is spread through the blood of an infected person. During hemodialysis, you must be injected with a needle so your blood can flow into the dialysis machine. Sometimes, you may get other shots of medicines or have blood tests done during your dialysis session.

Any time a needle is used to take blood, there is a chance the blood (even a very small amount) can get on a surface or an object where it is not supposed to be. If the blood of a patient with hepatitis C touches a surface or an object, and the surface or object is not cleaned in the right way, a contamination can happen.

If supplies or equipment used for your dialysis treatment are contaminated with blood infected with hepatitis C, you could get the hepatitis C virus.

Your chance of getting hepatitis C from hemodialysis is small because dialysis centers are required to follow strict safety rules that keep contaminations from happening.

If these safety rules are broken, hepatitis C can spread during hemodialysis through:

• Contamination of medicines
• Contamination of the medicine supply cart used to bring medicines from patient to patient
• Contamination of the dialysis machine
• Contamination of needles or vials (small containers used to hold medicines)
• Contamination of gloves used by nurse or doctor to treat patients

Preventing hepatitis C in dialysis centers

Medical professionals that work in dialysis centers are required to take infection control trainings and are required to follow safe practices. Some of the safety recommendations for dialysis center staff to follow for preventing hepatitis C in dialysis centers are to:

• Use only one vial (small container used to hold medicines) per patient.
• Never combine medicines left over in vials from multiple patients.
• Never use the same needle or syringe (the tube attached to the needle for injecting medicines) for multiple patients.
• Never use the same intravenous (IV) solution (bags of fluid) for multiple patients.
• Always disinfect supplies or equipment used during treatments that involve blood.
• Keep clean materials physically separate from materials that could be contaminated with blood.
• Prepare medicines for patients in a space that is physically separate from areas that could be contaminated with blood.
• Always put on new gloves between patients.
• Wash hands in the correct way after touching anything that could be contaminated by blood.

Although getting hepatitis C in a dialysis center is not very common, doctors recommend dialysis patients get tested regularly. If you are starting hemodialysis, most centers will test you for hepatitis C before your first treatment. You can expect to be tested for hepatitis C about every 6–12 months for as long as you are doing in-center hemodialysis.

Peritoneal dialysis

Peritoneal dialysis (PD)is another type of dialysis that is usually done at home. PD uses the lining of your abdomen (belly area), called your peritoneum, and a cleaning solution called dialysate to clean your blood. During PD, blood never comes out of your body like it does during hemodialysis. This is why there is less risk for getting hepatitis C when doing PD.

Reporting a safety concern

If you ever feel concerned about the safety practices in your dialysis center, you can tell a staff member. If you do not want to tell someone at your center, you can contact your state's ESRD network or State Department of Health to file a grievance (submit a complaint). Never feel afraid to speak up about something you think is not right. It could protect you and others. To contact your ESRD network or State Department of Health, follow the links below.

ESRD Networks

State Department of Health