**Type-A reactions**

The symptoms may start with dyspnea, fear of death, and a sensation of heat in the fistula site or the whole body and end with a complete anaphylactic episode. In less severe cases, there may be symptoms such as itching, coughing, sneezing, nasal discharge, nausea and vomiting. These generally occur at the very beginning of dialysis, but may also appear between the 15th and 20th minutes. Such reactions are seen more in patients with atopy and/or eosinophilia (Walter &Taraba, 1991).

The criteria developed by Daugirdas and Ing. are mostly used in diagnosis. The major criteria include the reaction occurring in the first 20 minutes after the beginning of dialysis, dyspnea, sensation of burning or heating-up in the access site or diffused to the whole body and angioedema whereas the minor criteria include recurrence of the reaction during the next dialysis session when the same class or type dialyzer is used, urticaria, rhinorrhea or lacrimation, abdominal cramps and itching. Diagnosis is made when three major or two major and 1 minor criteria are met (Daugirdas & Ing, 1988).

It is mostly caused by sterilization using ethylene oxide, other reasons being the use of an AN69 membrane, reuse, complementary fragment release and eosinophilia (Shaldon & Koch, 1995).
