Abstract

Forty-one patients on our chronic hemodialysis program were assessed for the degree of progression of bone disease over an average period of 46 months. Seven patients were using a fluoridated dialysate. Four of these seven patients developed a marked increase in osteoid as judged by bone biopsy, while in the nonfluoridated group the amount of osteoid remained within normal limits. In the absence of fluoride, although osteitis fibrosa occurred, it was reversible in 10 out of 12 cases by dihydrotachysterol treatment, and overall there was no evidence of progression of bone disease at the end of the study period.

Excerpt:

In conclusion, we believe our experience indicates that patients maintained on long-term hemodialysis using fluoridated water for periods of years will encounter an unacceptable frequency and degree of osteomalacia. Although some bone disease, in the form of osteitis fibrosa, occurs in patients using nonfluoridated water, this is usually reversible by treatment with dihydrotachysterol. It therefore seems prudent to use nonfluoridated water in long-term hemodialysis.

Print PDF

• Related Studies :

  • Association between fluoride, magnesium, aluminum and bone quality in renal osteodystrophy

    INTRODUCTION: Trace elements are known to influence bone metabolism; however, their effects may be exacerbated in renal failure because dialysis patients are unable to excrete excess elements properly. Our study correlated bone quality in dialysis patients with levels of bone fluoride, magnesium, and aluminum. A number of studies have linked

  • Effect of fluoride on aluminum-induced bone disease in rats with renal failure

    Aluminum (Al) accumulation in renal failure is an etiological factor in the pathogenesis of low turnover bone disease. Aluminum-induced impairment of mineralization has been related to a reduced extent of active bone-forming surface. The present study investigated the effect of fluoride, a potent stimulator of osteoblast number, on the toxicity

  • Effects of dialysate calcium and fluoride on bone disease during regular hemodialysis

    A previous study indicated that, in patients maintained by hemodialysis, clinically and roentgenographically apparent bone disease appeared almost exclusively when the dialystate calcium concentration was less than 5.7 mg per 100 ml. In the present study, bone biopsy specimens from the iliac crest were studied at the beginning and end

  • Changing patterns of renal osteodystrophy with chronic hemodialysis

    The concept that osteomalacia becomes progressively worse on chronic dialysis was reinforced by the findings in the repeat bone biopsies in that 6 of the 8 patients showed a significant increase in their osteoid index. . . . Thus, the progression of osteomalacia appears to be the main reason for

  • [Histomorphometric profile of bone fluorosis induced by prolonged ingestion of Vichy Saint-Yorre water. Comparison with bone fluorine levels].

    Nine transiliac bone biopsies from 7 patients with skeletal fluorosis due to prolonged ingestion of often high quantities of Vichy Saint-Yorre water were analyzed. Four of these patients also suffered from a chronic renal failure. A histomorphometric study was possible in 8 out of the 9 biopsies. The measurement of bone fluoride

• Related FAN Content :

  • Fluoride & Osteomalacia

    One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been

  • Fluoridation, Dialysis & Osteomalacia

    In the 1960s and 1970s, doctors discovered that patients receiving kidney dialysis were accumulating very high levels of fluoride in their bones and blood, and that this exposure was associated with severe forms of osteomalacia, a bone-softening disease that leads to weak bones and often excruciating bone pain. Based on

  • Similarities between Skeletal Fluorosis and Renal Osteodystrophy

    It is quite possible, and indeed likely, that some kidney patients diagnosed with renal osteodystrophy are either suffering from skeletal fluorosis or their condition is being complicated/exacerbated by fluoride exposure.

  • Fluoride & Rickets

    One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid (unmineralized bone) content of bone. When bones have too much osteoid, they become soft and prone to fracture -- a condition known as osteomalacia. When osteomalacia develops during childhood, it is called "rickets." The potential for fluoride

  • Fluoride Increases Osteoid Content of Bone

    Fluoride's ability to increase the osteoid content of bone is now undisputed. Osteoid is an unmineralized tissue in bone that, in the normal bone remodeling process, ultimately becomes calcified. As some observers have noted, "[t]he main histological change induced by fluoride is the increase of osteoid volume." (Arnala 1985). One way fluoride