Little data is available concerning the relationship between variations in ionic plasma fluoride (IPF) concentrations and some diseases, and that which exists is inconclusive. The effect of renal insufficiency is known best, but the relationship between IPF levels and some oedematous diseases and diabetes has hardly been studied at all in man. The purpose of this study was therefore to obtain more information on the IPF concentrations of patients suffering from renal and/or cardiac insufficiency, liver cirrhosis, rheumatoid arthritis and juvenile diabetes mellitus.
The subjects of the study were the in-patients at Kuopio University Central Hospital who lived within the city boundaries (the drinking water in the city of Kuopio contains 1.0-1.2.
ppm fluoride). Probable diagnosis, age, sex, fasting IPF concentration and serum level were recorded or determined for every patient. The IPF concentrations were measured with a fluoride electrode and the serum creatinine levels with a Technicon AutoAnalyzer. As expected, the mean IPF concentration of renally affected patients (1.6 ± 0.76 umol/l) was higher than that of controls of the same mean age (1.2 ± 0.41 umoI/I). One patient who had undergone peritoneal dialysis displayed the highest level in the whole study (11.0 umol/l).
The individuals with cardiac insufficiency had mean IPF levels even higher than the renal patients (1.9 ± 0.80 umol/l). Subjects suffering from both cardiac insufficiency and renal impairment had the highest mean IPF concenration (2.4 ± 0.72 umol/l), although the mean serum creatinine concentration of the renal patients was higher. The results suggest that cardiac insufficiency and moderate renal failure may cause equal fluoride retention. The mean IPF level of the patients with liver chirrosis (1.8 ± 0.56 umol/l) was also slightly elevated, perhaps because of extracellular water retention. The difference, however, was not statistically significant. Elevated IPF levels could be found in patients with rheumatoid arthritis only if renal complication had resulted from the disease.
Finally the children with diabetes mellitus did not have exceptionally higher IPF levels than the controls because these patients were not fasting as the controls were.