Studies on serum fluoride and bone metabolism in patients with long term hemodialysis

Abstract

With growing experience of the long-term treatment of patients with end stage renal disease by hemodialysis, the safety of fluoridated water supply for dialysate and the effect on the bone metabolism has been discussed.

In this study, concentrations of fluoride (F), calcium (Ga). aluminum (AI) and biochemical indices of bone metabolism, such as bone gla protein (BGP), parathyroid hormone (PTH), alkaline phosphatase (ALP) in serum, and the bone mineral density of both radius (radial-BD) and lumbar spine (spinal-BD) were analyzed in 95 patients (45 males and 50 females) with hemodialysis to clarify the combined effects of F concentration and treatment of hemodialysis on the bone metabolism in those patients.

Serum F, BOP, and PTH in the patients with hemodialysis were significantly higher than those in healthy subjects. Although radial-BD decreased with duration of hemodialysis in both male and female patients, spinal-BD did not parallel to the changes in radial·BD. In the correlation matrices of the observation items in the patients. the pairs of items having a good correlation coefficient were F and BGP, F and spinal-BD, BGP and PTH in male subjects. and F and ALP, BGP and PTH in female patients.

From these results. it was suggested that absorbed F strongly affected the metabolism of bone, especially cancellous bone in the patients with long-term hemodialysis.