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

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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 after starting hemodialysis. This may indicate that fluoridation is not universally associated with the development of osteodystrophy and/or that if osteodystrophy does develop in response to fluoridation, it may take years before it is radiographically appreciated.

3. The rates of bone uptake of dialysate fluoride and bone clearance of intravenously administered fluoride were both single exponential curves with similar slopes.

4. Rectilinear bone scans with F18 showed that, within the limits of the sensitivity of the technique, there is exclusive bone uptake of fluoride in uremic patients.