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.
Discussion
These data indicate that a patient maintained by hemodialysis in a community using fluoridated water may be exposed to a fluoride concentration higher than that present in tap water if the deionizer is allowed to become exhausted while the patient is being dialyzed. The concentration reached 520 uM in the laboratory deionizer and 230 M in the patient's model. Since the concentration of fluoride in blood returning from the dialyzer is about one-half to two-thirds that in the dialysate
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Fluorine is a poison with a broad spectrum of action affecting the metabolic processes, tissue respiration, and neuroendocrine regulation. For this reason, even before affecting the bones, occupational fluorosis manifests itself clinically as a generalized disease with syndromes affecting a number of important systems and organs, including the nervous system.
The neurotoxic effect of fluorine compounds has been proven by numerous experimental studies (A. F. Aksyuk and G. V. Bulychev; S. K. Bi
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