Which water contaminants may cause methemoglobinemia?

Methemoglobinemia is a condition in which hemoglobin is oxidized to methemoglobin, which is unable to effectively bind oxygen, leading to reduced oxygen delivery to tissues. Understanding the causes of this condition is crucial in the context of water contamination, especially for patients undergoing hemodialysis.

Nitrates, commonly found in agricultural runoff, can convert to nitrites in the human body, which can lead to the formation of methemoglobin. This is particularly dangerous for infants, as their hemoglobin is more susceptible to oxidation. Additionally, chloramines, which are used as disinfectants in water treatment, can also contribute to the risk of methemoglobinemia by similarly promoting the conversion of hemoglobin to its oxidized form. Therefore, exposure to water containing high levels of nitrates or chloramines can result in methemoglobinemia.

This understanding highlights the significance of monitoring water quality in dialysis settings, as patients with compromised kidney function are particularly vulnerable to the effects of contaminants. By ensuring water used for dialysis is free from these harmful substances, healthcare providers can help mitigate the risk of methemoglobinemia among patients.