In our hemodialysis center, opened in April 1964, fluoridated dialysis began with the fluoridation of the city water supply in November 1965. Our subsequent therapeutic failure was completely unexpected and a possible explanation was suggested by the observation of Taves et al. that the serum fluoride levels in patients chronically hemodialyzed with fluoridated water are comparable to those that cause fluorotic bone disease. Thus, the study of fluoride levels in our patients became of particular
Summary
These data show that:
1. During a 2 year period, the chronic use of fluoridated water in patients undergoing maintenance hemodialysis was associated with a rise in serum phosphatase in 10 of 20 patients studied and an increased radiographic incidence of osteodystrophy.
2. Eight long-term hemodialysis patients manifested no radiographic evidence of osteodystrophy during their first 2 to 6 years of hemodialysis, and one of these patients currently has a negative bone survey, 9 years aft
