Abstract

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    Endemic skeletal fluorosis is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride either through water or rarely from foods of endemic areas. Fluoride is a cumulative toxin which can alter accretion and resorption of bone tissue. It also affects the homeostasis of bone mineral

  • Renal failure and fluorosis

    Two patients had a combination of renal insufficiency and systemic fluorosis. One had bilateral vesicoureteral reflux and recurrent pyelonephritis, with resulting renal atrophy; the other had probable renal dysgenesis of indeterminate origin. Both patients had polydipsia, polyuria, and markedly reduced renal function. Both also had clinical and roentgenographic evidence of

  • Fluoride-related bone disease associated with habitual tea consumption

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  • Fluoridation and bone disease in renal patients

    About the Authors: William J Johnson, director of the Mayo Artificial Kidney Center and professor of medicine with the Division of Nephrology at the Mayo Clinic, has been involved in the study of calcium and phosphorus metabolism and renal osteodystrophy, potassium metabolism, and uremic neuropathy. He is past chairman of the Minnesota

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    It is well established that individuals with kidney disease are susceptible to suffering bone damage and other ill effects from low levels of fluoride exposure. Kidney patients are at elevated risk because when kidneys are damaged they are unable to efficiently excrete fluoride from the body. As a result, kidney patients

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    The available evidence suggests that some patients wtih long-term renal failure are being affected by drinking water with as little as 2 ppm fluoride. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers. The finding of adverse effects in patients drinking water with 2 ppm of fluoride suggests that a few similar cases may be found in patients imbibing 1 ppm, especially if large volumes are consumed, or in heavy tea drinkers and if fluoride is indeed the cause. It would seem prudent, therefore, to monitor the fluoride intake of patients with renal failure living in high fluoride areas.

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    One of the common fallacies in the research on skeletal fluorosis is the notion that there is a uniform level of fluoride that is safe for everyone in the population. These "safety thresholds" have been expressed in terms of (a) bone fluoride content, (b) daily dose, (c) water fluoride level, (d) urinary fluoride level, and (e) blood fluoride level. The central fallacy with each of these alleged safety thresholds, however, is that they ignore the wide range of individual susceptibility in how people respond to toxic substances, including fluoride.

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