在洗腎患者的貧血，維他命B12不論是口服或注射都是常用藥物。這篇文章提到一位年輕患者，神智不清，急性腎損傷，低體溫，代謝性酸中毒，疑似Cyanide中毒，因此給予注射Hydroxocobalamin 解毒（FDA 2006）。後來患者要透析時，透析機Fresenius 2008K，一直出現“blood leak alarm”, 更換人工腎臟也是一樣的警告，後來只好改CVVH 。
原因呢？
Hydroxocobalamin causes an orange/red discoloration of bodily fluids and can permeate dialysate. This can lead to dialysis failure due to defraction of light from discolored dialysate, resulting in triggering of the blood leak sensor in certain hemodialysis machines. The case highlights the need for an awareness of hydroxocobalamin effects in hemodialysis and its potential to delay initiation of emergent dialysis in critically-ill patients.
原文：
Proc (Bayl Univ Med Cent). 2017 Apr;30(2):167-168.
Hemodialysis failure due to Hydroxocobalamin
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