Abstract
The safety of fluoridated community water supplies for dialysate and long-term intermittent hemodialysis has been questioned since 1965 [1]. The only significant means of clearing fluoride from body fluids are renal excretion and incorporation into bone [2]. When dialysate is prepared with fluoridated water, fluoride ion moves along a concentration gradient from dialysate to blood [3, 4]. Because rental excretion is defective or absent in such patients, the fluoride administered during dialysis is incorporated into the skeleton. Under these conditions, serum fluoride concentrations increase progressively, and the bone content of fluoride rises above values obtained in persons with normal renal function who drink water that is fluoridated [3-6] (the serumfluroride concentraiton in normal persons who drink water with a fluoride concentration of 5µm [1 ppm] is 0.7 +-.4µm [mean +-SD]. Although it has not been established that fluoridated dialysate adversely affects the bone of patients maintained by hemodialysis, this possibility exists, particularly in patients who have been exposed to such a dialysate for many years. This and other problems associated with various substances in tap water may actually increase as the deionizer becomes exhausted.
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Effects of fluoride on bone metabolism in patients with hemodialysis
The maior pathway of fluoride elimination from the human body is the kidney. The discharge of fluoride into urine depends on the clearance of the kidney. Fluoride in serum of hemodialysis patients is higher than that of healthy subjects. Fluoride is not reduced sufficiently with hemodialysis. Those patients are in
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High fluoride concentrations in the serum and bone of patients with chronic renal failure
The aim was to study the effect of ingested fluoride in patients with chronic renal failure (CRF). Serum fluoride concentrations were measured in 104 subjects, who formed three groups: nondialyzed CRF, dialyzed CRF, and a control group. The iliac bone fluoride was measured in 20 subjects. Serum, urine and water
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Renal osteodystrophy in patients on long-term hemodialysis with fluoridated water
Serum and bone fluoride concentrations of ten patients maintained on long-term hemodialysis with fluoridated water (1 ppm, i.e., 50uM) were correlated with duration of treatment and the occurrence of clinical, radiological, and histological manifestations of bone disease. Two patients had symptomatic renal osteodystrophy when accepted on the program, whereas six
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Bone fluoride in patients with uremia maintained by chronic hemodialysis
Bone specimens from 42 patients with end-stage renal disease and from 9 patients without renal or bone disease have been analyzed for the content of fluoride, calcium, and phosphorus. Thirty-one patients were treated with chronic hemodialysis for periods ranging up to 56 months by employing dialysate made up with tap
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Serum ionic fluoride levels in haemodialysis and continuous ambulatory peritoneal dialysis patients
High serum fluoride (F-) in patients with chronic renal failure (CRF) and end-stage renal disease (ESRD) is associated with risk of renal osteodystrophy and other bone changes. This study was done to determine F- in normal healthy controls and patients with ESRD on haemodialysis (HD) or peritoneal dialysis (PD). Seventeen
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Fluoride & Osteomalacia
One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been
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Skeletal Fluorosis in the U.S.
Although there has been a notable absence of systematic studies on skeletal fluorosis in the U.S., the available evidence indicates that the consumption of artificially fluoridated water is likely to cause skeletal fluorosis and other forms of bone disease in people with kidney disease and other vulnerable populations.
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Kidney Patients Are at Increased Risk of Fluoride Poisoning
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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Exposure Pathways Linked to Skeletal Fluorosis
Excessive fluoride exposure from any source -- and from all sources combined -- can cause skeletal fluorosis. Some exposure pathways , however, have been specifically identified as placing individuals at risk of skeletal fluorosis. These exposure pathways include: Fluoridated Water for Kidney Patients Excessive Tea Consumption High-Fluoride Well Water Industrial Fluoride Exposure Fluorinated Pharmaceuticals (Voriconazole
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Similarities between Skeletal Fluorosis and Renal Osteodystrophy
It is quite possible, and indeed likely, that some kidney patients diagnosed with renal osteodystrophy are either suffering from skeletal fluorosis or their condition is being complicated/exacerbated by fluoride exposure.
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